【摘要】：目的:研究冠狀動(dòng)脈(冠脈)內(nèi)注射替羅非班治療在急性ST段抬高型心肌梗死(STEMI)病變血管再通患者急診PCI應(yīng)用中的臨床療效。方法:選取火箭軍總醫(yī)院2012-1-2016-01收治的STEMI患者,經(jīng)冠脈造影證實(shí)病變血管再通并行急診PCI患者191例,分為替羅非班組(108例)及對照組(83例)。替羅非班組患者在常規(guī)PCI操作基礎(chǔ)上,給予冠脈內(nèi)注射替羅非班10μg/kg。比較兩組患者病變相關(guān)血管(IRA)的TIMI血流分級和手術(shù)成功率,進(jìn)一步隨訪觀察2組患者30d及12個(gè)月心血管不良事件發(fā)生率(MACE)及出血事件,并通過超聲心動(dòng)圖評估心臟功能及結(jié)構(gòu)。結(jié)果:對于IRA再通的STEMI患者,冠脈內(nèi)注射替羅非班可以顯著促進(jìn)PCI術(shù)后IRA血流恢復(fù),減少術(shù)后早期及晚期心力衰竭的發(fā)生,不增加出血事件,減少平均住院天數(shù)。心臟超聲結(jié)果發(fā)現(xiàn),冠脈內(nèi)注射替羅非班顯著提高患者遠(yuǎn)期心臟功能。結(jié)論:對于IRA自發(fā)再通的STEMI患者,直接冠脈內(nèi)注射替羅非班能夠提高心肌再灌注,增加心臟功能,改善患者預(yù)后,安全可行。
[Abstract]:Objective: to study the clinical effect of intracoronary injection of tirofiban in patients with acute ST segment elevation myocardial infarction (ST) undergoing (STEMI) revascularization. Methods: 191 patients with STEMI, confirmed by coronary angiography, were divided into two groups: tirofiban group (n = 108) and control group (n = 83). Patients in the tirofiban group were given 10 渭 g / kg of tirofiban by intracoronary injection on the basis of routine PCI procedures. The TIMI blood flow classification and surgical success rate of (IRA) were compared between the two groups. The incidence of cardiovascular adverse events (MACE) and bleeding events were observed at 30 days and 12 months in the two groups. The cardiac function and structure were evaluated by echocardiography. Results: for STEMI patients with IRA recanalization, intracoronary injection of tirofiban significantly promoted the recovery of IRA blood flow after PCI, reduced the incidence of early and late postoperative heart failure, did not increase bleeding events, and reduced the average hospital stay. The results of echocardiography showed that intracoronary injection of tirofiban significantly improved long-term cardiac function. Conclusion: for STEMI patients with spontaneous recanalization of IRA, direct intracoronary injection of tirofiban can improve myocardial reperfusion, increase cardiac function, improve prognosis and be safe and feasible.
【作者單位】： 中國人民解放軍火箭軍總醫(yī)院心血管內(nèi)科;
【分類號】：R542.22

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