血栓抽吸联合替罗非班治疗血栓负荷病变疗效观察

Effect of Thrombus Aspiration and Tirofiban on Patients with Thrombotic Burden Lesion

目的探讨DiverCE导管血栓抽吸与血小板糖蛋白Ⅱb/Ⅲa受体拮抗剂替罗非班联合治疗急性心肌梗死血栓负荷病变的疗效。方法32例经冠脉造影证实为血栓负荷病变的急性心肌梗死患者分为血栓抽吸+替罗非班组24例、标准经皮冠状动脉介入治疗(PCI)组8例,比较两组患者住院期间主要心脏不良事件(MACE)的发生率、手术前后的心肌梗死溶栓(TIMI)血流变化和出血性并发症发生率。结果血栓抽吸+替罗非班组住院期间的MACE发生率低于标准PCI组(P<0.05),术后即刻TIMI血流改善率高于标准PCI组,而且无致命性出血并发症。结论DiverCE导管血栓抽吸与替罗非班联合治疗急性心肌梗死血栓负荷病变是安全、有效的治疗方法。

Objective To investigate the effect of both thrombus aspiration device Diver CE and tirofiban therapy on patients of acute myocardial infarction （AMI） with coronary thrombotic burden lesion. Methods 32 patients of AMI with thrombotic burden lesion confirmed by coronary angiography were divided into the aspiration catheter and tirofiban group （n= 24） and standard percutaneous coronary intervention （PCI） group （n= 8）. The rate of major adverse cardiovascular events （MACE） in hospital, changes before and after the therapy of two groups were compared. Results MACE incidence in hospital in the patients of the both thrombus aspiration and tirofiban group was obviously lower than that of the standard PCI group （P 〈0.05）. The thrombolysis in myocadial infarction （TIMI） after therapy in the thrombus aspiration group improved superior to the standard PCI group. All of two groups had no fatal hemorrhagic complications. Conclusion Combination of thrombus aspiration and tirofiban is a safe and effective method to manage the thrombotic burden lesion in AMI patients.