本文選題：依替巴肽　切入點：心肌梗死　出處：《中國循環(huán)雜志》2016年09期 　論文類型：期刊論文

【摘要】：目的:評價冠狀動脈內(nèi)應(yīng)用依替巴肽對急性心肌梗死(AMI)患者冠狀動脈無復(fù)流和心肌灌注的影響。方法:急診經(jīng)皮冠狀動脈介入治療(PCI)的ST段抬高型AMI(STAMI)患者80例,隨機分為依替巴肽組40例和對照組40例。比較兩組患者的基線資料,PCI術(shù)后血管再通情況及用藥前后血小板聚集率變化。手術(shù)后即刻及24周時查超聲心動圖;術(shù)后1周查心肌灌注顯像。隨訪24周,觀察主要不良心血管事件(MACE)發(fā)生率。結(jié)果 :與對照組比,依替巴肽組在PCI術(shù)后心肌梗死溶栓治療臨床試驗(TIMI)血流3級比例(72.5%vs 92.5%)及TIMI心肌灌注3級比例(70.0%vs 90.0%)均顯著升高(P均0.05)。依替巴肽組術(shù)后及停藥后2 h血小板聚集率均較術(shù)前有顯著性降低,且較對照組同時段降低,差異均有統(tǒng)計學(xué)意義(P均0.05)。依替巴肽組術(shù)后24周左心室舒張末直徑及左心室射血分?jǐn)?shù)較術(shù)后1周有顯著性改善,且均優(yōu)于對照組(P均0.05)。依替巴肽組用藥期間發(fā)生小出血事件7例(17.5%),對照組發(fā)生小出血事件3例(7.5%),兩組比較差異無統(tǒng)計學(xué)意義(P0.05)。兩組患者均無大出血事件發(fā)生,住院期間均無血小板減少事件發(fā)生。兩組24周隨訪MACE發(fā)生率(12.5%vs 22.5%)比較,差異無統(tǒng)計學(xué)意義(P0.05)。結(jié)論:在STAMI患者行急診PCI時,冠狀動脈內(nèi)應(yīng)用依替巴肽可有效改善冠狀動脈血流,增加心肌灌注,明顯改善患者心功能。冠狀動脈內(nèi)應(yīng)用依替巴肽不增加大出血風(fēng)險,并且隨訪24周,不增加MACE發(fā)生率。
[Abstract]:Objective: to evaluate the effect of intracoronary etibatin on coronary artery no-reflow and myocardial perfusion in patients with acute myocardial infarction (AMI). Methods: 80 patients with ST-segment elevation AMI (St segment elevation AMI) undergoing emergency percutaneous coronary intervention (PCI) were enrolled in this study. The patients were randomly divided into two groups: Etibatin group (n = 40) and control group (n = 40). The baseline data of the two groups were compared, and the blood vessel recanalization and platelet aggregation rate before and after PCI were compared. Echocardiography was performed immediately after operation and 24 weeks after PCI. Myocardial perfusion imaging was performed 1 week after operation. 24 weeks follow-up was followed to observe the incidence of major adverse cardiovascular events (MACEE). Results: compared with the control group, Clinical trial of thrombolytic therapy in patients with myocardial infarction after PCI. It was significantly lower than that before operation. The mean left ventricular end-diastolic diameter and left ventricular ejection fraction at 24 weeks after operation were significantly improved in Etibatin group compared with those in control group at the same time, and the difference was statistically significant (P < 0.05). It was better than the control group (P < 0.05). There were 7 cases of small hemorrhage in Etibatin group and 3 cases of small hemorrhage event in control group (P < 0.05). There was no significant difference between the two groups (P 0.05). There was no thrombocytopenia during hospitalization. There was no significant difference in the incidence of MACE between the two groups after 24 weeks follow-up (P 0.05 vs 22. 5). Conclusion: when patients with STAMI are undergoing emergency PCI, the coronary artery blood flow can be improved effectively by intracoronary administration of etibapeptide. Increased myocardial perfusion significantly improved the cardiac function of the patients. The risk of massive hemorrhage was not increased by intracoronary administration of etibapeptide, and 24 weeks follow-up showed no increase in the incidence of MACE.
【作者單位】： 河北醫(yī)科大學(xué)第二醫(yī)院心內(nèi)科;
【分類號】：R542.22

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