比伐芦定联合冠脉内注射替罗非班预防ST段抬高型心肌梗死患者PCI术中无复流的效果  

Effect of Bivalirudin Combined with Intra-Coronary Injection of Tirofiban on Preventing No-reflow during PCI in Patients with ST Segment Elevation Myocardial Infarction

作　　者：房勇 阳成俊 刘青平 谭启林 邹小秋 巫玉婷 FANG Yong;YANG Chengjun;LIU Qingping;TAN Qilin;ZOU Xiaoqiu;WU Yuting(Department of Cardiology,Yichun Second People's Hospital,Yichun 336000,China;不详)

机构地区：[1]宜春市第二人民医院心血管内科,江西宜春336000

出　　处：《中国医学创新》2024年第18期23-27,共5页Medical Innovation of China

基　　金：江西省卫生健康委普通科技计划项目(202212624)。

摘　　要：目的:观察比伐芦定联合冠脉内注射替罗非班预防ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)术中无复流的效果。方法:选取2018年1月—2022年6月宜春市第二人民医院收治的95例STEMI患者,随机分成对照组(n=40)和观察组(n=45)。对照组预防性冠脉内注射替罗非班,观察组采用比伐芦定联合冠脉内注射替罗非班治疗,统计分析两组术中无复流发生率、心肌梗死溶栓治疗(TIMI)帧数、TIMI血流分级、心血管不良事件发生情况、并发症发生情况。结果:观察组术中无复流发生率、PCI术后,TIMI帧数低于对照组,TIMI血流分级优于对照组,差异均有统计学意义(P<0.05)。观察组心血管不良事件总发生率低于对照组,差异有统计学意义(P<0.05)。两组出血并发症总发生率比较,差异无统计学意义(P>0.05)。结论:与预防性冠脉内注射替罗非班相比,比伐芦定联合冠脉内注射替罗非班更能对STEMI患者PCI术中无复流进行有效防治,有助于制订预防无复流个体化治疗方案,以获得较好的即刻靶血管血流及后期良好疗效。Objective:To observe the effect of Bivalirudin combined with intra-coronary injection of Tirofiban on preventing of no-reflow during percutaneous coronary intervention(PCI)in patients with ST segment elevation myocardial infarction(STEMI).Method:A total of 95 patients with STEMI admitted to Yichun Second People's Hospital from January 2018 to June 2022 were selected and randomly divided into control group(n=40)and observation group(n=45).The control group was treated with preventive intra-coronary injection of Tirofiban,while the observation group was treated with Bivalirudin combined with intra-coronary injection of Tirofiban.The incidence of intraoperative reflow,thrombolysis in myocardial infarction(TIMI)frame number,TIMI blood flow grade,occurrence of cardiovascular adverse events,and complications of the two groups were statistically analyzed.Result:The incidence of no-reflow and TIMI frame number after PCI in observation group were lower than those in control group,and TIMI blood flow grade after PCI was better than that in control group,the differences were statistically significant(P<0.05).The total incidence of cardiovascular adverse events in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).There was no significant difference in the total incidence of bleeding complications between the two groups(P>0.05).Conclusion:Compared with preventive intra-coronary injection of Tirofiban,Bivalirudin combined with intra-coronary injection of Tirofiban is more effective in preventing and treating no-reflow during PCI in STEMI patients,which is helpful for formulating individualized treatment plan for preventing no-reflow,so as to obtain better immediate target blood flow and good curative effect in later period.

关 键 词：ST段抬高型心肌梗死 经皮冠状动脉介入治疗 无复流 比伐芦定 冠脉内注射替罗非班 心血管不良事件 出血并发症 

分 类 号：R542.22[医药卫生—心血管疾病]