血小板Ⅱb／Ⅲa受体拮抗剂联合药物洗脱支架治疗急性心肌梗死临床观察

Observation of the effect of homemade tirofiban combined with the drug eluting stent on the treatment of acute myocardial infarction

目的探讨血小板Ⅱb／Ⅲa受体拮抗剂——替罗非班（欣维宁）联合药物洗脱支架治疗急性心肌梗死（AMI）的安全性和有效性。方法因AMI行经皮腔内冠状动脉介入（PCI）治疗的患者52例，于置入药物洗脱支架前予国产替罗非班（欣维宁）负荷量后，以维持量持续静脉泵入48h，观察手术成功率、围手术期出血血栓并发症及1～3个月的主要心脏不良事件（包括死亡，靶血管再次重建术）和出血发生。结果52例患者PCI均取得成功，手术成功率100％，无严重出血并发症，无急性、亚急性血栓及慢血流发生。治疗无死亡，无再发心梗及靶血管再次血运重建，围手术期血小板聚集率明显降低。结论欣维宁联合药物洗脱支架行急诊PCI治疗急性心肌梗死安全有效，不增加出血危险性，可明显降低围手术期及近期并发症。

Objective To evaluate the safety and efficiency of homemade tirofiban combined with drug-eluting stent in the treatment of acute myocardial infarction. Methods Fifty-two cases of myocardial infarction patients were used the load dose homemade tirofiban （Xinweining） before the pereutanenous coronary interventions （ PCI ）, then pumped for 48 hours with the sustaining dose. The success rate of operations, peri-operational bleeding and thrombosis complications and main adverse cardiac events were observed, the platelet aggregation rate was monitored. Results Fifty-two patients were all performed PCI successfully, the success rate of operation was 100 %, there were no serious bleeding complications, acute or subaeute intra-stent thrombosis and slow reflow phenomenon occurred. There were no re-infarction and target vascular reperfusion occurred. The platelet aggregation rate were obviously decreased during peri-operation. Conclusion Homemade tirofiban combined with drug-eluting stent, which is safety and efficiency in the treatment of acute myocardial infarction, can obviously decrease the complications of perioperation and short term.