替罗非班联合血栓抽吸对急诊PCI患者的近期疗效观察

Term efficacy of tirofiban combine thrombus aspiration in patients undergo emergency PCI

目的：观察替罗非班联合血栓抽吸对急性ST段抬高型心肌梗死（STEMI）行急诊PCI患者的近期疗效。方法：选择行急诊PCI术的STEMI患者68例,梗死相关血管（IRA）血流TIMI 0-1级。其中37例行替罗非班联合血栓抽吸（血栓抽吸组）,另外31例经传统方法完成PCI术（传统PCI组）。比较两组患者IRA的TIMI血流分级、无复流/慢血流发生率、术中术后并发症及术后30 d内主要心脏不良事件（MACE）发生率。结果：与传统PCI组相比,血栓抽吸组再灌注心律失常、出血、血肿等术中及术后并发症并没有减少（P〉0.05）。但血栓抽吸组IRA术后TIMI血流分级明显高于传统PCI组（P〈0.05）,无复流/慢血流发生率、球囊使用例数及术后30 d部分MACE发生率低于传统PCI组,差异有统计学意义（P〈0.05）。结论：替罗非班联合血栓抽吸能够改善STEMI患者急诊PCI术后IRA血流,降低无复流/慢血流现象及近期MACE的发生率,显著改善STEMI患者的近期预后。

Objective： To study the term efficacy of tirofiban combine thrombus aspiration in patients with acute ST-segment elevation myocardial infarction（ STEMI） undergo emergency percutaneous coronary intervention（ PCI）.Methods： Sixty-eight patients with STEMI received emergency PCI were selected. All the infarct-related coronary arteries（ IRA） flow was TIMI 0-1 grade. Thirty-seven patients in the thrombus aspiration group received tirofiban and thrombus aspiration,Other thirty-one patients in the conventional PCI group received routine PCI. TIMI blood flow,no reflow or slow flow incidence of IRA after PCI,intraoperative and postoperative complications and major cardiac adverse event（ MACE） within 30 days in the two groups were compared. Results： Compared with the conventional PCI group,intraoperative and postoperative complications（ such as reperfusion arrhythmias,bleeding,hematoma,etc.） in the thrombus aspiration group didn’t reduce（ P 〉 0. 05）. But the grade of IRA TIMI blood flow in the thrombus-aspiration group was significantly higher than that of the conventional PCI group（ P 〈 0. 05）. In addition,the incidence of no reflow or slow flow,numbers of patients using balloon and partly MACE occurrence in the thrombus aspiration group was significantly lower than that of the conventional PCI group within 30 days（ P 〈0. 05）. Conclusion： Tirofiban combine thrombus aspiration can improve IRA blood flow and reduce no-reflow /slow-flow phenomenon in STEMI patients after emergency PCI,also can decrease recent incidence of MACE and significantly improve term prognosis of patients with STEMI.