摘要
目的观察盐酸替罗非班对行急诊冠脉介入治疗的ST段抬高型心肌梗死(STEMI)患者近期临床疗效影响,探讨其作用机制。方法将95例行急诊介入治疗的STEMI患者随机分为两组,实验组于术前给予盐酸替罗非班静注。检测两组在介入术中及术后24、72 h凝血因子(TF、vWF)、细胞黏附分子(sICAM-1、sVCAM-1)水平,并观察记录心肌组织呈色分级(MBG)、校正TIMI计帧数(CTFC)、心电图ST段回落幅度及住院期间、术后30 d主要不良心脏事件(MACE)等。结果与对照组比较,实验组术后凝血因子、黏附分子水平显著降低(P均<0.05),再通后90 min ST段回落幅度、MBG分级增加(P<0.05),CTFC帧数减少(P<0.05),MAC发生率显著降低(P<0.05)。结论替罗非班能降低AMI患者急诊PCI术后炎症反应,提高介入术后心肌组织灌注,改善近期临床预后;其机制与降低凝血因子、细胞黏附分子水平有关。
Obejective To investigate the effect of tirofiban on clinical prognosis in the near future of patients with STEMI treated by primary percutaneous coronary intervention. Methods 95 patients with STEMI disease were treated by PCI, and randomly divided into treatment and control group. The patients in treatment group were treated by tirofiban before transplanting stents. All the patients were drawed blood from elbow venous during operation, 24h and 72h after PCI. sICAM-1 ,sVCAM-1 and cogulation factor （TF, vWF） were dected and the following index were recorded ：corrected TIMI frame count, myocardial blush grades , the st-segment degression degree and cardiac major adverse cardic events during inhospital and in 30 days after PCI. Results Compared with the control group, the following index of the treatment group decreased significantly ： the level of TF, vWF, sICAM-1 and sVCAM-1 （ P 〈 0.05 ）, the corrected TIMI frame count （ P 〈 0.05 ） , the cardiac MACE during hospital and in 30 days after PCI. The following index of treatment group increased significantly ： ST-segment degression in 90 mi autos after reperfusion （ P 〈 0.05 ） , the rate of blush 3 grade. Conclusions Tirofiban treatment can improve clinical outcome of the patients with STEMI treated by PCI in the near future.
出处
《山东医药》
CAS
北大核心
2008年第29期27-29,共3页
Shandong Medical Journal
关键词
替罗非班
急性心肌梗死
经皮冠状动脉介入治疗
炎症因子
组织因子
tirofiban
acute myocardial infarction
percutaneous coronary intervention
tissue factor
solube adhesion molecules
