血栓抽吸和替罗非班在心肌梗死经皮冠状动脉介入手术中的应用

Clinical efficacy of thrombus aspiration combined with tirofiban in myocardial infarction patients

目的探讨在经皮冠状动脉介入（PCI）手术中应用血栓抽吸联合替罗非班的临床疗效。方法将164例急性心肌梗死患者完全随机分为观察组和对照组，各82例。对照组行常规PCI术；观察组在术中以10μg／kg的剂量静脉推注盐酸替罗非班，推注时间为3min，然后以0．10μg／（kg·min）的速度小剂量静脉滴注24—36h，并实施血栓抽吸，再置入支架。比较2组患者术后心肌梗死溶栓试验（TIMI）血流分级情况、心电图sT段回落情况、左心室射血分数（LVEF）、无复流发生率及主要心血管不良事件（MACE）发生率。结果观察组TIMI3级比例、sT段回落以及LVEF明显高于对照组[90．2％（74／82）比76．8％（63／82），85．4％（70／82）比72．0％（59／82），（64±6）％比（52±5）％]，观察组MACE及无复流发生率明显低于对照组[2．4％（2／82）比10．1％（9／82），4．9％（4／82）比14．6％（12／82）]，差异均有统计学意义（均P〈0．05）。结论PCI术中血栓抽吸联合替罗非班可有效增强急性心肌梗死患者行PCI的疗效。

Objective To investigate the clinical efficacy of thrombus aspiration combined with tirofiban in percutaneous coronary intervention（PCI） surgery. Methods All 164 patients with acute myocardial infarction were randomly divided into observation group （82 cases） and control group （82 cases ）. The control group received conventional PCI operation. The observation group received 10 μg/kg hydrochloric tirofiban intravenous pushed within 3 min and kept 0.10μg/（ kg . min）for 2±36 h by intravenous dripping, then received thrombus aspiration. The thrombolysis in myocardial infarction （TIMI） grade, electrocardiogram ST segment, left ventricular ejection fraction （LVEF） , no-reflow and major adverse cardiovascular events （MACE） were compared between two groups. Results The observation group was significantly higher than the control group in TIMI 3, ST segment proportion and left ventricular ejection fraction [ 90.2% （74/82） vs 76.8% （63/82）, 85.4% （70/82） vs 72.0% （59/82）, （64 ± 6）% vs （52 ± 5 ）%, P 〈 0.05 ], the observation group was significantly less than the control group in MACE and no-reflow proportion [2.4% （2/82） vs 10. 1% （9/82）, 4.9% （4/82） vs 14.6% （ 12/82）, P 〈 0. 05]. Conclusion It might enhanced PCI efficacy with thrombus aspiration combined with tirofiban in PCI.