摘要
目的评价冠状动脉内注射替罗非班对急性ST段抬高型心肌梗死(STEMI)患者急诊经皮冠状动脉介入治疗(PCI)后无复流发生率的影响。方法将120例STEMI患者分为替罗非班组(替罗非班+直接PCI,60例)和对照组(直接PCI,60例)。PCI术中根据TIMI血流分级、TIMI计帧法(cTFC)评价冠状动脉血流。术后24h进行实时心肌声学造影检查,计算心肌灌注缺损计分指数(CSI)及室壁运动计分指数(WMSI)。分析术后1h2组患者心电图sT段偏移总和比值(sumSTR)的变化。结果替罗非班组TIM13级血流显著多于对照组(P〈0.05),而cTFC显著低于对照组(P〈0.05);替罗非班组与对照组相比CSI(1.23±0.33.1.38±0.43,P〈0.05),WMSI(1.52±0.39:1.70±0.38;P〈0.05)均显著降低;与对照组比较,替罗非班组术后1hsumSTR〉70%比例更高(P〈0.05)。结论冠状动脉内注射替罗非班能改善STEMI患者PCI术后心肌血流,防止无复流的发生。
Objective To evaluate the influence of intracoronary tirofiban on the incidence of no reflow after percutaneous coronary intervention ( PCI ) in patients with acute ST segment elevation myocardial infarction ( STEMI ). Methods 120 STEMI patients were divided into tirofiban group ( tirofiban and direct PCI, n = 60 ) and control group ( direct PCI, n = 60 ). During PCI, coronary flow was evaluated according to TIMI flow grading and corrected TIMI frame count ( cTFC ). The changes in sum ST segment resolution ( sumSTR ) were compared one hour after PCI; myocardial perfusion defect score index ( CSI ) and wall motion score index ( WMSI ) were computed 24 hours after PCI according to myocardial contrast echocardiography ( MCE ). Results The blood flow of TIMI grade 3 was greater in tirofiban group than in the control group ( P 〈 0.05 ) and cTFC was significantly lower in tirofiban group than in the control group ( P〈 0.01 );, CSI and WMSI were was significantly lower in tirofiban group than in the control group ( 1.23 ± 0.33 vs. 1.38± 0.43, 1.52 ±0.39 vs. 1.70±0.38; P〈 0.05 ); the ratio of sumSTR 〉 70% was significantly higher in the tirofiban group than in the control group ( P 〈 0.05 ). Conclusions Intracoronary tirofiban can improve myocardial blood flow in STEMI patients after PCI and can prevent the occurrence of no reflow.
出处
《国际医药卫生导报》
2011年第21期2643-2645,共3页
International Medicine and Health Guidance News
关键词
心肌梗死
替罗非班
经皮冠状动脉介入治疗
无复流
Myocardial infarction
Tirofiban
Percutaneous coronary intervention
No reflow