急性ST段抬高型心肌梗死患者支架植入术后早期应用替罗非班的效果观察

Intracoronary Flow Influence of Early Use of GP Ⅱb/Ⅲa Receptor Antagonists Tirofiban in Patients with STEMI after Intracoronary Stenting Use and Short-term out Comes

目的:探讨对于急性ST段抬高型心肌梗死(STEMI)患者,早期应用血小板膜糖蛋白Ⅱb/Ⅲa受体拮抗剂替罗非班对患者支架植入术后冠脉血流及近期预后的影响。方法:入选沈阳医学院沈洲医院2006年6月～2009年8月急性STEMI并行PCI治疗的患者72例,其中,男性49例,女性23例,平均年龄(57.8±7.1)岁,随机分组(替罗非班早期应用组,即试验组n=34例)与(替罗非班常规应用组,即对照组,n=38例)。收集所有患者临床和CAG资料,对比两组患者支架植入术后冠脉血流再灌注情况及近期主要心血管事件(MACE)的发生情况。结果:试验组与对照组相比,PCI术中无复流及慢血流的发生率明显低于对照组,(P<0.05);住院期间的主要心血管事件发生率,试验组明显低于对照组,(P<0.05);而出血的发生率两组之间无统计学意义(P>0.05)。结论:对于急性STEMI患者,尽早应用血小板膜糖蛋白Ⅱb/Ⅲa受体拮抗剂替罗非班,可以明显降低PCI术中无复流及慢血流的发生率,明显降低(MACE)的发生率,且不增加出血的几率。

Objective：To study intracoronary flow influence of early use of GP II b/Ilia receptor antagonists tirofiban in patients with STEMI after intracoronary stenting use and short-term out comes.Methods：Seventy-two STEMI patients（49 males,23 females,mean age （57.8±7.1）years old admitted during june,2006 to August 2009 were include in the study from shenzhou Hospital of Shenyang Medical College. The patients were divided into the early use tirofiban group （n=34） and the common use tirofiban group（n=38）.Changes in coronary flow injection and MACE were observed after intracoronary stentingResults：The incidence of slow-flow and no-reflow of the early use tirofiban group was lower than that of the common use tirofiban group （P〈0.05）;the rate of MACE was all lower than that of common use tirofiban group（P〈0.05）;the rate of blooding was no sense of statistics between these two groups. Conclusion：Early use of GP Ⅱb/Ⅲa receptor antagonists tirofibanin patient with STEMI is feasible and can reduce not only the rate of no-reflow,slow flow and MACE during operation,but also increase the rate of blooding.