血栓抽吸与替罗非班的不同应用顺序对急诊经皮冠状动脉介入术后慢血流或无复流的影响

Influence of slow / no- reflow after different sequences of thrombus aspiration and tirofiban in primary percutaneous coronary interventions

目的对比不同顺序应用血栓抽吸及替罗非班对预防急性心肌梗死行急诊经皮冠状动脉治疗(PCI)术后冠状动脉慢血流或无复流的影响。方法 97例急性ST段抬高性心肌梗死(STEMI)患者被计算机随机分为治疗组(49例,先冠脉内注射替罗非班后行血栓抽吸)和对照组(48例,先行血栓抽吸再行冠脉内替罗非班注射),支架植入术后分析两组发生慢血流或无复流的发生率,另外比较患者出院前左室射血分数(LVEF)、住院期间心血管事件(MACE)及住院期间出血事件的发生率。结果两组在慢血流和无复流的发生率差异无统计学意义(P>0.05),出院前左室射血分数、住院期间心血管事件及出院期间出血事件均差异无统计学意义(均P>0.05)。结论与先行血栓抽吸再行冠脉内注射替罗非班相比,先冠脉内注射替罗非班后再行血栓抽吸,在预防急诊PCI术后慢血流或无复流现象的效果相当。

Objective To compare the clinical irdluence of slow/no - reflow after different sequences of thrombus aspiration and tirofiban in primary percutaneous coronary interventions for acute myocardial infarction. Method Ninety - seven cases of acute STEMI patients were randomly divided into treatment grop （ n = 49, intracoronary use of tirofiban before thrombosis suction） and control group （n = 48 ,thrombosis suction before intracoronary use of tirofiban） by computer. The occurrence rate of slow/no -reflow,left ventricular ejection fraction（ LVEF）, major adverse cardiovascular events （MACE） and bleeding events after PCI were compared between two groups. Results There was no significance between treatment and control group in the occurrence rate of slow/no - reflow ）, LVEF, MACE and bleeding events were no significant difference between two groups after treatment （P 〉 0.05 ）. Conclusion The two ways of intracoronary use of tirofiban and thrombus aspiration are safe and effective for preventing slow/no - reflow, and improve myocardial perfusion and prognosis in the near future.