【摘要】：目的觀察阿托伐他汀聯(lián)合替羅非班在ST段抬高型急性心肌梗死(STEMI)患者經(jīng)皮冠狀動脈介入(PCI)治療中的應(yīng)用效果。方法將存在無復(fù)流高風(fēng)險的STEMI患者172例隨機分為觀察組94例和對照組78例,兩組均行急診PCI治療,觀察組術(shù)前口服阿托伐他汀80 mg、術(shù)中冠狀動脈內(nèi)注射替羅非班,對照組冠狀動脈內(nèi)注射尿激酶;術(shù)后兩組均口服阿托伐他汀40 mg/d,應(yīng)用7 d后減為20 mg/d,連用6個月。觀察兩組無復(fù)流發(fā)生情況、術(shù)后72 h內(nèi)心肌灌注情況,統(tǒng)計術(shù)后6個月主要不良心臟事件(MACE)發(fā)生率。結(jié)果觀察組、對照組術(shù)后無復(fù)流發(fā)生率分別為3.19%(3/94)、26.92%(21/78),組間差異具有統(tǒng)計學(xué)意義(P0.05);觀察組術(shù)后72 h內(nèi)心肌灌注速度和心肌血流量均明顯大于對照組(P均0.05);術(shù)后隨訪6個月,觀察組MACE發(fā)生率明顯低于對照組(P0.05)。結(jié)論大劑量阿托伐他汀聯(lián)合替羅非班用于STEMI患者PCI治療,可降低術(shù)后無復(fù)流發(fā)生率,增加心肌組織灌注,改善預(yù)后。
[Abstract]:Objective to observe the effect of Atto vastatin combined with tirofiban on percutaneous coronary intervention (PCI) in patients with St segment elevation acute myocardial infarction (St segment elevation acute myocardial infarction). Methods 172 STEMI patients with high risk of no reflow were randomly divided into the observation group (n = 94) and the control group (n = 78). The patients in both groups were treated with emergency PCI. The patients in the observation group were given Atto vastatin 80 mg before operation and tirofiban was injected intraoperatively into the coronary artery. In the control group, urokinase was injected into the coronary artery, and Atto vastatin 40 mg / d was taken orally in both groups. After 7 days, it was reduced to 20 mg / d for 6 months. No reflow occurred in the two groups, myocardial perfusion was observed within 72 hours after operation, and the incidence of major adverse cardiac events (MACE) at 6 months after operation was counted. Results in the observation group, the incidence of no reflow was 3.19% (3 / 94) or 26.92% (21 / 78) in the control group, the difference between the two groups was statistically significant (P0.05), the myocardial perfusion velocity and myocardial blood flow in the observation group were significantly higher than those in the control group within 72 hours after operation (P 0.05). The incidence of MACE in the observation group was significantly lower than that in the control group (P0.05). Conclusion High dose of Atto vastatin combined with tirofiban in the treatment of PCI in patients with STEMI can reduce the incidence of no reflow, increase myocardial perfusion and improve prognosis.
【作者單位】： 羅定市人民醫(yī)院;
【分類號】：R542.22

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