摘要
目的评价直接PCI术中冠状动脉内注射血小板糖蛋白Ⅱb/Ⅲa受体拮抗剂替罗非班的安全性及其对术后患者心肌灌注、心功能的影响。方法将我院收治的101例急性心肌梗死患者随机分为替罗非班组(52例)和对照组(49例)。观察两组患者术后心肌梗死溶栓试验(TIMI)血流分级、校正TIMI计帧数、心肌灌注分级(TMPG),发病时肌酸激酶(CK)及其同工酶CK-MB峰值,出院前左室射血分数(EF)和左心室舒张末期内径(EDD),心血管事件及出血并发症。结果两组患者临床事件、出血并发症发生率间差别无统计学意义(P>0.05)。PCI术后两组患者最终造影TIMI3级血流获得率间差别无统计学意义(P>0.05);校正TIMI计帧数均值及TMPG2~3级患者所占比例间差别均有统计学意义(P<0.05)。出院前两组患者EF、EDD间差别有统计学意义(P<0.05)。发病后两组患者CK-MB峰值间差别有亦统计学意义(P<0.01)。结论直接PCI术中冠状动脉内注射替罗非班有助于改善冠脉血流和心肌灌注,保护心功能,且不增加出血并发症。
Objective To study the effect of intracoronary injection of glycoprotein Ⅱb/Ⅲa receptor blockade tirofiban on coronary flow and myocardial perfusion in patients with acute ST-elevation myocardial infarction(STEMI)treated by primary percutaneous coronary intervention(PCI).Methods 101 consecutive AMI patients,treated by primary coronary angioplasty,were enrolled in this study.The Patients were divided into two groups according to whether tirofiban was used intracoronary or not.Baseline characteristics of the two groups were compared.At the end of PCI procedure angiographic features,such as TIMI flow grade,corrected TIMI frames count and TMP grade were analyzed immediately.Also some clinical features after primary PCI,such as LVEDD,LVEF and Peak serum of CK-MB were compared between two groups.Results There was no significant difference between two groups in bleeding and occurrence of MACE(P〉0.05).There was no significant difference between two groups in basic clinical or angiographic characteristics before PCI(P〉0.05).There was no significant difference between two groups in percentage of TIMI-3 flow achieved in IRAs after PCI(P〉0.05).In contract tirofiban group corrected TIMI frames count was significant lower than control group(P〈0.01),Tirofiban group also achieved higher percentage of IRAs TMP grade 2-3(P〈0.05).In clinical feature tirofiban group the peak serum CK-MB was significant lower than control group(P〈0.01),Tirofiban group had higher EF and smaller EDD than control group at the time before discharge(P〈0.05).Conclusion Intracoronary inject tirofiban during primary PCI in patients with AMI can improve coronary flow and myocardium perfusion,and which has no more bleeding and occurrence.
出处
《中国全科医学》
CAS
CSCD
2007年第22期1876-1878,共3页
Chinese General Practice
关键词
心肌梗死
介入治疗
替罗非班
心肌再灌注
Myocardial infarction
Percutaneous coronary intervention
Tirifiban
Myocardium reperfusion