目的探讨替格瑞洛联合替罗非班三种不同给药途径治疗急性ST段抬高型心肌梗死(STEMI)的应用价值。方法选取2018年1月至2020年4月湛江中心人民医院诊治的300例急性STEMI患者为研究对象,采用随机数字表法将患者分为A、B和C组,每组各100例。...目的探讨替格瑞洛联合替罗非班三种不同给药途径治疗急性ST段抬高型心肌梗死(STEMI)的应用价值。方法选取2018年1月至2020年4月湛江中心人民医院诊治的300例急性STEMI患者为研究对象,采用随机数字表法将患者分为A、B和C组,每组各100例。A组给予替格瑞洛联合静脉注射替罗非班,B组给予替格瑞洛联合输注替罗非班到冠状动脉,C组给予替格瑞洛联合输注替罗非班到病变部位。比较三组的大血管血流灌注指标、心肌微循环指标、住院期间出血情况和出院3个月的随访结果。结果三组PCI术后即刻TIMI分级和出血发生率比较,差异均无统计学意义(P>0.05)。与A组比较,B组和C组的CK-MB峰值降低,CK-MB峰值时间均明显早,PCI术后90 min ST段回落>50%构成比明显高(P<0.05或0.0125)。与B组比较,C组的CK-MB峰值明显低,CK-MB峰值时间明显早,PCI术后90 min ST段回落>50%构成比明显高(P<0.05或0.0125)。结论替格瑞洛联合输注替罗非班到病变部位治疗急性STEMI可提高心肌微循环灌注。展开更多
Background Atrial fibrillation(AF)is reported to be associated with worse flow in patients with the treatment of coronary thrombolysis. However,few studies investigated the impact of atrial fibrillation on the noreflo...Background Atrial fibrillation(AF)is reported to be associated with worse flow in patients with the treatment of coronary thrombolysis. However,few studies investigated the impact of atrial fibrillation on the noreflow phenomenon in ST-segment elevation myocardial infarction(STEIMI)patients undergoing primary percutaneous intervention(PCI). Methods 1163 STEMI patients undergoing primary PCI from Jan 2013 to Dec2019 were enrolled. Atrial fibrillation was diagnosed based on the electrocardiogram’s findings. Patients with a TIMI flow rate less than 3 were considered to have no-reflow. Factors related to the no-reflow phenomenon was analyzed by the logistic regression analysis. Results 158 patients were in the AF group and 1005 patients were in the non-AF group. The AF group had a significantly higher occurrence of cardiogenic shock(11.4% vs. 5.6%,P<0.001),and in-hospital mortality(9.5% vs. 3.1%,P<0.001)than the non-AF group. The multivariate analysis showed that AF was an independent risk factor for the no-reflow phenomenon after primary PCI(OR:2.11,95% CI:1.27-3.88,P=0.014). Conclusions STEMI patients with AF would have higher in-hospital adverse events and no-reflow phenomenon than though without AF.展开更多
文摘目的探讨替格瑞洛联合替罗非班三种不同给药途径治疗急性ST段抬高型心肌梗死(STEMI)的应用价值。方法选取2018年1月至2020年4月湛江中心人民医院诊治的300例急性STEMI患者为研究对象,采用随机数字表法将患者分为A、B和C组,每组各100例。A组给予替格瑞洛联合静脉注射替罗非班,B组给予替格瑞洛联合输注替罗非班到冠状动脉,C组给予替格瑞洛联合输注替罗非班到病变部位。比较三组的大血管血流灌注指标、心肌微循环指标、住院期间出血情况和出院3个月的随访结果。结果三组PCI术后即刻TIMI分级和出血发生率比较,差异均无统计学意义(P>0.05)。与A组比较,B组和C组的CK-MB峰值降低,CK-MB峰值时间均明显早,PCI术后90 min ST段回落>50%构成比明显高(P<0.05或0.0125)。与B组比较,C组的CK-MB峰值明显低,CK-MB峰值时间明显早,PCI术后90 min ST段回落>50%构成比明显高(P<0.05或0.0125)。结论替格瑞洛联合输注替罗非班到病变部位治疗急性STEMI可提高心肌微循环灌注。
文摘Background Atrial fibrillation(AF)is reported to be associated with worse flow in patients with the treatment of coronary thrombolysis. However,few studies investigated the impact of atrial fibrillation on the noreflow phenomenon in ST-segment elevation myocardial infarction(STEIMI)patients undergoing primary percutaneous intervention(PCI). Methods 1163 STEMI patients undergoing primary PCI from Jan 2013 to Dec2019 were enrolled. Atrial fibrillation was diagnosed based on the electrocardiogram’s findings. Patients with a TIMI flow rate less than 3 were considered to have no-reflow. Factors related to the no-reflow phenomenon was analyzed by the logistic regression analysis. Results 158 patients were in the AF group and 1005 patients were in the non-AF group. The AF group had a significantly higher occurrence of cardiogenic shock(11.4% vs. 5.6%,P<0.001),and in-hospital mortality(9.5% vs. 3.1%,P<0.001)than the non-AF group. The multivariate analysis showed that AF was an independent risk factor for the no-reflow phenomenon after primary PCI(OR:2.11,95% CI:1.27-3.88,P=0.014). Conclusions STEMI patients with AF would have higher in-hospital adverse events and no-reflow phenomenon than though without AF.
