摘要
目的:研究冠状动脉(冠脉)内注射替罗非班治疗在急性ST段抬高型心肌梗死(STEMI)病变血管再通患者急诊PCI应用中的临床疗效。方法:选取火箭军总医院2012-1-2016-01收治的STEMI患者,经冠脉造影证实病变血管再通并行急诊PCI患者191例,分为替罗非班组(108例)及对照组(83例)。替罗非班组患者在常规PCI操作基础上,给予冠脉内注射替罗非班10μg/kg。比较两组患者病变相关血管(IRA)的TIMI血流分级和手术成功率,进一步随访观察2组患者30d及12个月心血管不良事件发生率(MACE)及出血事件,并通过超声心动图评估心脏功能及结构。结果:对于IRA再通的STEMI患者,冠脉内注射替罗非班可以显著促进PCI术后IRA血流恢复,减少术后早期及晚期心力衰竭的发生,不增加出血事件,减少平均住院天数。心脏超声结果发现,冠脉内注射替罗非班显著提高患者远期心脏功能。结论:对于IRA自发再通的STEMI患者,直接冠脉内注射替罗非班能够提高心肌再灌注,增加心脏功能,改善患者预后,安全可行。
Objective： To explore the efficacy of direct intra-coronary injection of Tirofiban in patients with ST-segment elevated myocardial infarction （STEMI） and infarct-related artery （IRA） spontaneous reperfusion （SR）. Method： A total of 191 STEMI patients with IRA spontaneous reperfusion, which was confirmed by coronary angiography （CAG） from Jan 2012 to Jan 2016, were divided into Tirofiban group and control group. The control group was treated with conventional therapy. However, the patients in Tirofiban group were treated with direct intra-coronary injection of Tirofiban on the basis of the conventional PCI. Thrombolysis In Myocardial Infarction （TIMI） grade of IRA, MACE and incident of bleeding were compared between 2 groups. Furthermore, the heart function was evaluated by ultrasonic cardiogram （UCG）. Result： Compared with control group, the TIMI grade of IRA after PCI was improved by direct intra-coronary injection of Tirofiban. Meanwhile, the incidence of heart failure after PCI and the average length of stay （ALOS） were decreased in Tirofiban group. However, Tirofiban did not increase the incidence of bleeding. Moreover, UCG results demonstrated that the heart function in patients with STEMI was significantly improved by direct intra-coronary injection of Tirofiban. Conclusion： Direct intra-coronary injection of Tirofiban is a safe and efficient strategy to increase the myocardial perfusion, improve heart function and improve the clinic prognosis of patients with STEMI and infarct-related artery spontaneous reperfusion.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2017年第3期222-225,共4页
Journal of Clinical Cardiology
