替罗非班及血栓抽吸在急性ST段抬高型心肌梗死直接PCI术中的应用

Use of Tirofiban and Thrombus Aspiration During Primary Percutaneous Coronary Intervention

目的:评价静脉注射替罗非班及血栓抽吸在急性ST段抬高型心肌梗死(STEMI)患者的直接经皮冠状动脉介入治疗(PCI)中,对患者预后的影响。方法:以2010-02～2012-02间入院,诊断为急性STEMI患者,联合使用替罗非班(GPIIb/IIIa受体拮抗剂)及血栓抽吸直接PCI患者共36例,作为研究组。以2008-02～2010-02入院,诊断为急性STEMI并接受直接PCI的患者共48例作为对照组。比较两组无复流现象的改善和严重心脏不良事件(MACE)的发生以及术后2周的射血分数。结果:研究组较对照组血流TIME3级明显增加,ST段完全回落比例增加,术后心功能改善,术后严重心脏不良事件(MACE)的发生减少。结论:急性ST段抬高型心肌梗死患者直接PCI中,联合使用静脉注射替罗非班及血栓抽吸行与常规PCI相比,不仅能有效降低血栓负荷,防止无复流,增加心肌的有效灌注,而且改善患者预后。

Objective： To evaluate the effect of tirofiban and thrombus aspiration during emergency percutaneous coronary intervention （PCI） in patients with acute ST segment elevation myocardial infarction （STEMI）. Methods： From February 2010 to February 2012 36 STEMI patients recived tirofiban and thrombus aspiration during emergency percutaneous coro- nary intervention were enrolled in the study group, and from February 2009 to January 2010 48 STEMI patients recived e- mergency percutaneous coronary intervention were enrolled in the control group. Results：ST segment resolution, TIMI3 flow, rate of distal embolization, and aver age left ventricular ejection fraction in a week were significantly improved in the study group compared to the control group. Conclusions： The combine of tirofiban and thrombus aspiration can reduce thrombus burden ,prevent the rate of no reflow , improve myocardial perfusion and improve prognosis in patients with STEMI during direct PCI.