联合应用血栓抽吸及冠状动脉内注射替罗非班的安全性和有效性

Safety and effectiveness of combination application of thrombus aspiration and intracoronary injection of tirofiban

目的探讨在直接经皮冠状动脉介入治疗(PCI)术中,联合应用血栓抽吸和冠状动脉内注射替罗非班对急性前壁心肌梗死患者的梗死相关血管存在重度血栓负荷的介入治疗效果及临床预后的影响。方法回顾性研究该院2012年11月至2015年11月收治的急性前壁心肌梗死行直接PCI治疗的患者265例。A组为直接PCI术中单纯应用血栓抽吸;B组为直接PCI术中联合应用血栓抽吸及冠状动脉内注射替罗非班。结果 B组的TIMI心肌灌注分级(TMP)<3级的患者明显少于A组(P<0.05);心脏核磁共振检查(CMRI)结果显示,B组患者的心肌坏死面积明显低于A组(P<0.05);术后6个月的心脏彩超结果显示,B组的左室舒张末期容积(LVDD)和左室射血分数(LVEF)明显优于A组(P<0.05)。结论在直接PCI术中联合应用血栓抽吸和冠状动脉内注射替罗非班安全,有效。

Objective To investigate the interventional therapy effect of combination applieation of thromhus aspiration and intracoronary injection of tirofiban for treating heavy thrombosis burden of infarction related vessel in the patients with acute anterior myocardial infarction. Methods The patients with acute anterior myocardial infarction undergone direet primary percutaneous coronary intervention in the hospital were retrospectively analyzed. The group A received simple thrombus aspiration during trans- cutaneous PCI and the group B received the combination treatment of thrombus aspiration and intraeoronary mjeetion of tirofiban m direct PCI. Results The patients with myocardial perfusion grade less than 3 during thrombolysis during myocardial infarction（TI- MI） in the group B were significantly less than those in the group A（P〈（0.05）. The cardiac magnetic resonance imaging（MRI）-resuits indicated that the area of myocardial infarction in the group B was smaller than that in the group A（P〈0.05）. The color echocardiography results showed that the left ventricular diastolic volume（LVDV） and left ventricular ejection fraction（LVEF） in the group B were significantly better than those in the group A（P〈0.05）. Conclusion The combination application of thrombus aspiration and intracoronary injection of tirofiban is safe and effective in direct PCI.