血栓抽吸联合冠脉及静脉内小剂量注射替罗非班对急诊经皮冠状动脉介入的疗效及预后的影响

Influence of Thrombus Aspiration Combined with Low-dose Intra-coronary and Intravenous Injection of Tirofiban on the Efficacy and Prognosis of Emergency Percutaneous Coronary Intervention

【目的】评价冠状动脉（冠脉）内血栓抽吸联合冠脉及静脉内小剂量注射替罗非班对急性ST段抬高型心肌梗死（STEMI）急诊经皮冠脉介入（PCI）的治疗效果及预后。【方法】选择接受直接PCI治疗的STEMI患者62例，随机分为冠脉内血栓抽吸联合冠脉及静脉内小剂量注射血小板膜蛋白Ⅱb／IlIa（GPⅡb／llIa）受体拮抗剂替罗非班组（治疗组，32例）和常规PCI联合静脉内注射大剂量替罗非班组（对照组，30例），评估两组PCI前后梗死相关血管TIMI血流分级、术后6个月主要心血管事件（MACE）及术后出血情况。【结果】与对照组比较，治疗组无复流或慢复流现象显著减少，6个月MAcE、围术期出血发生率明显下降，且两组相比较差异有显著性（P〈0．05）。【结论】冠脉内血栓抽吸联合冠脉及静脉内小剂量注射替罗非班可有效改善STEMI患者梗死相关血管的血流，改善患者预后，并具有较好的安全性。

Objective To evaluate the efficacy and prognosis of thrombus aspiration combined with low-dose intra-coronary and intravenous injection of tirofiban for the treatment of patients with acute ST-segment elevation myocardial infarction（STEMI） receiving emergency percutaneous coronary intervention（PCI）. Methods Totally 62 patients with STEMI receiving direct PCI were randomly divided into thrombus aspiration combined with low- dose intra-coronary and intravenous injection of tirofiban treatment group （treatment group, n = 32） and routine PCI combined with intravenous injection of tirofiban group（control group, n = 30）. Blood flow TIMI grading of infarction-related vessels before and after PCI, major adverse cardiac events（MACE） 6 months after PCI and postoperative bleeding were observed in two groups. [Results] Compared with control group, the treatment group bad no reflow or significant reduction of slow reflow. MACE at 6 months and the incidence of perioperative bleeding in treatment group were obviously decreased. There were significant differences between two groups（ P 〈0. 05）. [ConclusionlThrombus aspiration combined with low-dose intra-coronary and intravenous injection of tirofiban can effectively improve blood flow of infarction-related vessels and the prognosis of patients with STEMI, and has good safety.