盐酸替罗非班对急性心肌梗死急诊经皮冠状动脉介入治疗中TIMI血流影响的临床研究

Effect of tirofiban on TIMI flow in patients with STEMI during primary PCI

目的分析Ⅱb/Ⅲa受体拮抗剂盐酸替罗非班对ST段抬高急性心肌梗死(STEMI)患者急诊经皮冠状动脉介入治疗(PCI)治疗中TIMI血流的影响。方法选择急诊入院STEMI患者48名,分为试验组(盐酸替罗非班+PCI)27例和对照组(直接PCI)21例。收集所有病例的临床和冠状动脉造影资料,观察PCI术前、术后TIMI血流情况。结果试验组于术前应用盐酸替罗非班使PCI前梗死相关血管TIMI血流分级提高,试验组达1级血流者比例高于对照组(37%比9.5%,P<0.05);对照组完全闭塞者比例明显高于试验组(38.1%比7.4%,P<0.01);两组患者PCI术后TIMI3级血流比例差异无统计学意义,TIMI2级血流比例试验组低于对照组。结论Ⅱb/Ⅲa受体拮抗剂盐酸替罗非班可改善STEMI患者梗死相关血管的TIMI血流。

Objective To eveluate the effect of tiroflban on TIMI flow in patients with SIEMI during primary PCI. Methods Forty-eight patients with STEMI who underwent primary PCI were randomly divided into two groups which were： the tirofiban ＋ PCI group （ n = 27） and the primary PCI group （ n = 21）. The TIMI flow before and after the operation were reviewed angiographically. Results A greater percentage of TIMI 1 flow was archieved in the triofiban＋ PCI group compared with the primary PCI group before operation （37% vs 9.5%, P 〈0.05）. On the other hand, TIMI 0 flow was more commonly found in patients in the primary PCI group compared with the tirofiban ＋ PCI group （38.1% vs 7.4%, P 〈 0.01） . There was no difference in the archievement of TIMI 3 flow between the two groups after operation, but the occurance of TIMI 2 flow was less in the tirofiban ＋ PCI group compared with the primary PCI group. Conclusion Tirofiban may improve TIMI flow of the IRA in patients with SIEMI during primary PCI.