AMI直接PTCA术应用血小板Ⅱb/Ⅲa受体拮抗剂的安全性及合理性

Safety and feasibility of using plateletⅡb/Ⅲa during direct percutaneous transluminal coronary angioplasty in patients with acute myocardial infarction

目的 探讨急性心肌梗塞 (acutemyocardialinfarction ,AMI)直接PTCA术应用血小板Ⅱb/Ⅲa受体拮抗剂abciximab的安全性及合理性和 30天临床随访结果。方法 30例胸痛小于 2hAMI施行直接PTCA术治疗的患者 ,静脉注射小剂量肝素 70U/kg和abciximab 0 2 5mg/kg ,随后abciximab以10 μg/min持续静脉滴注 12h ,观察 30天时死亡率、心肌梗塞、再次急诊冠脉血运重建术和出血发生率。结果 随访 30天 ,未见出血并发症 ,abciximab治疗无一例死亡 ,也未发生心肌梗塞和施行再次冠脉血运重建术。结论 在急性冠脉缺血综合征中 ,应用血小板Ⅱb/Ⅲa受体拮抗剂是安全合理的 ,血小板Ⅱb/Ⅲa受体拮抗剂不增加出血危险性 ,能降低AMI直接PTCA术后患者缺血并发症 。

Objective To investigate the safety and feasibility of using platelet Ⅱb/Ⅲa receptor antagonist during direct percutaneous transluminal coronary angioplasty (PTCA) and 30 day clinical observation following PTCA in patients with acute myocardial infarction (AMI) Methods Thirty patients with AMI were assigned to receive abciximab (0 25 mg/kg, i v following infusion of 10 μg/min for 12 h) plus low dose of heparin (70 u/kg) The end points at the end of 30 day were changes in all cause death, myocardial infarction, emergency coronary revascularization and bleeding complications Results At follow up of 30 day there was no bleeding occurance in abciximab group and there was no death, infarction and coronary revascularization Conclusion The application of platelet Ⅱb/Ⅲa receptor antagonist is safe and feasible in patients with acute coronary syndromes Bleeding complications are not increased when abciximab was used in patients with AMI Abciximab can reduce the incidence of ischemic complications of direct PTCA in patients with AMI and improve the outcomes after the procedure