国产替罗非班对急性心肌梗死冠状动脉介入治疗术后心肌灌注的影响

Effect of tirofiban on myocardial perfusion in patients with acute myocardial infarction treated by primary percutaneous coronary intervention

目的评价替罗非班在急性心肌梗死(AMI)直接冠状动脉介入治疗(PCI)中的有效性和安全性。方法行直接PCI治疗的AMI患者,分为预先应用替罗非班组(40例)和对照组(32例),比较两组患者的无复流发生率、心肌灌注分级(TMPG)和出血并发症。结果两组患者均成功完成PCI操作,试验组有4例(10%)出现无复流或慢复流现象,对照组共有8例(25%)出现无复流现象,试验组无复流发生率有低于对照组的趋势,但未达到显著水平,替罗非班组的TMPGⅢ级比例高于对照组,但未达到统计学显著水平,两组主要不良事件无显著性差异。两组患者总的出血并发症相似,均无严重出血并发症。结论国产替罗非班能降低AMI直接PCI时无复流现象,改善冠状动脉血流,且不增加严重出血并发症。

AIM To investigate the effect and safety of China-made tirofiban in patients with acute myocardial infarction treated by primary percutaneous coronary intervention. METHODS Seventy-two AMI patients were included in the study, who received either Tirofiban before the index procedure （ n = 40） or just PCI alone （n = 32）. The no reflow rate, TIMI myocardial perfusion grade （TMPG） , major adverse cardiovascular events （MACE） and bleeding complications were compared between the two groups. RESULTS PCI were successfully performed in all patients. The no reflow rate in Tirofiban group was not significantly lower than that in control group （ 10% versus 25% ） and the percentage of TMPG Ⅲ grade in Tirofiban group was not significantly higher than that in control group （45% versus 25% ）. MACE during hospitalization and bleeding complications had no significant differences between the two groups. CONCLUSION Tirofiban, a Glycoprotein Ⅱ b/Ⅲa receptor blocker, administrated in primary PCI of AMI patients can safely reduce no reflow rate and improve myocardial perfusion.