欣维宁在急诊经皮冠脉介入治疗的安全性研究

The safety study of tirofiban in patients with STEMI during emergency PCI

目的评价GPⅡb/Ⅲa受体拮抗剂盐酸替罗非班在ST段抬高急性心肌梗死(STEMI)急诊经皮冠状动脉腔内介入术(PCI)治疗中的安全性。方法 120例急诊入院STEMI行急诊PCI的患者,随机分为试验组(盐酸替罗非班+PCI)60例和对照组(直接PCI)60例。观察2组住院期间主要心血管事件(MACE)包括死亡、新近心肌梗死和顽固缺血状态、术后左心室射血分数(LVEF)、压迫止血时间及不良反应(出血、血小板减少)。结果住院期间MACE发生率,试验组略高于对照组(10%vs 6.7%,P>0.05);术后LVEF(56.97±8.41vs 54.15±7.11)高于对照组;2组均未发生严重出血并发症(包括大量出血和颅内出血等),出血事件发生率试验组较对照组有增多的趋势(8.3%比3.3%),试验组部分凝血活酶时间(APTT)较对照组延长(53.97±10.58 vs 32.51±6.31,P<0.05);压迫止血时间明显延长(38.16±5.37 vs 21.34±4.96,P<0.05),但未增加穿刺点出血和血肿。结论盐酸替罗非班联合PCI可能成为STEMI患者急诊PCI安全和有效的再灌注手段。

Objective To assess the safety of GP IIb/IIIa antagonists tirofiban in patients with STEMI during emergency PCI.Methods 120 patients with STEMI were divided into two groups,tirofiban＋PCI group（n=60） and primary PCI group（n=60）.The major adverse cardiovascular events（MACE） rates of two groups were compared including death,recen t myocardial infarction,persisten t myocardial ischemic state,cardiac function after operation（1ef t ventricular ejection fraction,LVEF）,compression hemostasia time and adverse drug effec t in hospital.Results MACE rates in tirofiban＋PCI group was higher than tha t in primary PCI group（10% vs 6.7%）;Postoperative LVEF in tirofiban＋PCI group were better than tha t in primary PCI group（56.97±8.41 vs 54.15±7.11）.There was an increasing tendency of the bleeding rates in tirofiban＋PCI group（8.3%vs 3.3%,P〉0.05）.APT t and compression hemostasia time in tirofiban＋PCI group were significan t prolonged（53.97±10.58 VS 32.51±6.31,P〈0.05）,bu t no more bleeding and hematoma occurred.Conclusions Tirofiban＋PCI may possibly become a safe and effective reperfusion method for STEMI patients during emergency PCI.