摘要
目的:观察国产替罗非班对直接经皮冠脉介入术(PCI)术后心肌微循环再灌注的疗效。方法:急性ST段抬高急性心肌梗塞(STEMI)直接PCI术病人95例,A组(45例)PCI术中给予国产替罗非班10μg/kg的负荷量,然后以0.15μg/kg·min静脉滴注维持18 h,B组(50例)术中不予替罗非班,两组患者均在PCI术后常规给予抗血小板药物口服、肝素泵入,对比给药前后的TIMI血流分级、校正的TIMI帧数(CTFC)及术前、术后ST段回落率及室壁运动记分(WMSI),围术期出血倾向。结果:A组患者治疗后TIMI血流分级、校正的TIMI帧数、ST段完全回落率明显优于B组(P<0.05),随访1月时,两组患者WMSI、EF均有改善,但A组的WMSI较B组改善更多(P<0.05),A组治疗期间轻微出血发生率高于B组(P<0.05)。结论:在阿司匹林和氯吡格雷基础上早期应用替罗非班,可减少STEMI再灌注后无再流或慢血流的发生,改善心肌微循环再灌注及病人预后。
Objective: To evaluate the effects of tirofiban on myocardium reperfusion after primary percutaneous coronary intervention (PCI). Methods: A total of 95 patients with ST elevation acute myocardial infarction, who underwent primary PCI, were randomized into two groups. Forty-five patients in group A were treated with tirofiban (10μg/kg bolus, 0. 15 μg/kg · min infusion for 18 h). Fifty patients in group B were treated routinely without tirofiban. All patients received antiplatelet preparation and intravenous heparin; the change of TIMI blood flow, corrected TIMI frame count (CTFC), degree of ST-segment recovery, ventricular wall motion score index (WMSI), rate of bleeding complication were compared between two groups. Results: TIMI blood flow, CTFC, degree of ST--segment recovery after treatment in group A were significant superior to group B (P〈0. 05). The WMSI and EF significantly improved at one month in both groups, but the ΔWMSI in group A were significantly higher than that of group B (P〈0. 05). There was increase of minor bleeding complication in group A (P〈0.05). Conclusion: Early application of tirofiban before primary PCI can decrease the probability of no-flow and slow-flow phenomenon, improve myocardial tissue reperfusion and the prognosis remarkably.
出处
《心血管康复医学杂志》
CAS
2008年第4期365-368,共4页
Chinese Journal of Cardiovascular Rehabilitation Medicine
关键词
替罗非班
血管成形术
经腔
经皮冠状动脉
微循环
(Tirofiban
Angioplasty, transluminal, percutaneous coronary artery
Microcirculation)