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冠状动脉内联合注射替罗非班和山莨菪碱对ST段抬高心肌梗死患者溶栓早期PCI心肌灌注改善作用的评价 被引量:7

Additive benefit of glycoprotein Ⅱb/Ⅲa inhibition and adjunctive anisodamine during early coronary intervention following thrombolysis on myocardial perfusion in patients with ST-segment elevation myocardial infarction
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摘要 尽早、充分、持久开通梗死相关动脉(infarctionrelated artery,IRA),保护左室功能,减少心肌梗死面积,是降低ST段抬高心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者死亡率、改善临床预后的关键^([1])。溶栓和直接经皮冠状动脉介入治疗(primary percutaneous coronary in tervention,PCI)作为STEMI再灌注治疗的主要方法,具有备自的优势和不足^([2])。近期研究表明,对于首诊于无PCI条件医院的STEMI患者。 Consecutive STEMI patients undergoing early PCI within 24 h of thrombolysis and admitted from December 2010 to December 2011 were randomly assigned to 4 groups:primary PCI group(PCI group),anisodsamine infusion group(ANI group),tirofiban infusion group(TIR group) and PCI with both treatments group(ANI+TIR group).PCI was performed according to the result of CAG.After coronary angiography,but before the first balloon inflation,patients in the ANI group and TIR+ ANI group received intracoronary bolus injection of anisodamine,and the same vulome of 0.9%sodium chloride in the other two groups.Tirofiban was administered in TIR group and ANI+TIR group and the same vulome of 0.9%sodium chloride in the remaining patients.TIMI flow grade(TFG),corrected TIMI frame count(CTFC),TIMI myocardial perfusion grade(TMPG) and thrombosis score before and after PCI were recorded.Serum creatine kinase(CK),MB fraction(CK-MB),and standard 12-lead ECGs were recorded at admission.Echocardiographic examination was performed at discharge by a cardiologist blinded to the randomization results.The occurrence of MACE was compared among the groups.There was a trend of more patients achieving post-procedural TIMI 3 flow in the ANI + TIR group,compared to the primary PCI group(95.8%vs.75.0%,P = 0.084).The post-procedural CTFC in ANI+TIR group was less than the other three groups(P = 0.002),while the post-procedural CTFC in both ANI group and TIR group were improved.There was also a possible interaction regarding CTFC with the P = 0.765 of anisodamine + tirofiban.There was a trend of more complete STR in both ANI group and TIR group than that in primary PCI group,and a significant difference of more complete STR in ANI+TIR group was found than that in primary PCI group(91.7%vs.58.3%,P = 0.039).There was a trend of high level of peak CK-MB in primary PCI group(P = 0.245).No significant difference of bleeding complications was found among groups.There was a trend of higher LVEF at discharge in the TIR+ANI group,compared to the primary PCI group[(56.19%±4.05%) vs.(50.70%±7.35%),P = 0.005)].No significant difference of occurrence of MACE was found among groups(P = 0.686).
出处 《临床心血管病杂志》 CAS CSCD 北大核心 2015年第12期1344-1349,共6页 Journal of Clinical Cardiology
基金 河北省2014年度医学科学研究重点课题计划(No:ZL20140074)
关键词 心肌梗死 溶栓治疗 经皮冠状动脉介入治疗 血小板糖蛋白Ⅱb/Ⅲa受体拮抗剂 山莨菪碱 ST-segment elevation myocardial infarction thrombolysis percutaneous coronary intervention glycoprotein Ⅱb/Ⅲa inhibition anisodamine
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  • 1Tu rker Y. Role of tirofiban with dual antiplatelet therapy in pa- tients with STEMI undergoing primary PCI [J]. Anatol J Car diol, 2015, 15(11):956.
  • 2Kaymaz C, Kele8 N,C) zdemir N, et al. The effects of tirofihan infusion on clinical and angiographic outcomes of patients with STEMIundergoing primary PCI [J].Anatol J Cardiol, 2015, 15 (11) :899-906.
  • 3Mrclovic I, Savic L, Lasica R, et al. Efficacy and safety of tiro- fiban-supported primary percutaneous coronary intervention in patients pretreated with 600 mg clopidogrel: results of propen sity analysis using the Clinical Center of SerbiaSTEMI Register [J]. Eur Heart J Acute Cardiovasc Care, 2014, 3(1) :56-66.
  • 4Rakowski T, Siudak Z, Dziewierz A, et al. Prehospital clopi- dogrel administration in patients with ST-segment elevation myocardial infarction treated with primary PCL: real life experi ence from the multicenter NRDES registry [J]. J Invasive Car- diol, 2016, 28(6):E56-58.
  • 5E1 Din Hadad E1 Shafey W. Modified revisiting of old balloon inflation technique during PCI for dealing with thrombus laden lesion in non-ST-segment elevation myocardial infarction EJ]. Indian Heart J, 2016, 68(2):202-204.
  • 6Fam JM, Felix C, van Geuns RJ, et al. Initial experience with everolimus-eluting bioresorbable vascular scaffolds for treat- ment of patients presenting with acute myocardial infarction: a propensity-matched comparison to metallic drug eluting stents 18-month follow-up of the BVS STEMI first study [J]. Eu- rolntervention, 2016, 12(1) :30-37.
  • 7Dudek D, Dziewierz A, Widimsky P, et al. Impact of prasugrel pretreatment and timing of coronary artery bypass grafting on clinical outcomes of patients with non-ST-segment elevation myocardial infarction:From the A comparison of prasugrel at PCI or time of diagnosis of non-ST-elevation myocardial infarc- tion (ACCOAST) study [J]. Am Heart J, 2015, 170(5) :1025- 1032.
  • 8Joy ER, Kurian J, Gale CP. Comparative effectiveness of pri mary PCI versus fibrinolytic therapy for ST elevation myoeardi- alinfarction: a review of the literature [J]. J Comp Elf Res, 2016, 5(2) :217-226.
  • 9Anderson RD, Pepine CJ. The coronary mieroeirculation in STEMI: The next frontier?[J]. Eur Heart J, 2015, 36(45): 3178 -3181.
  • 10Fro hlich GM, Landmesser U. Thrombus aspiration in STEMI revisitecl: impact on coronary microcirculation? [J].Open Heart, 2015, 2(1):e000274.

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