摘要
目的探讨替罗非班联合血栓抽吸对急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)效果的影响。方法选择2016年1月至2017年12月于焦作市人民医院行PCI的164例急性STEMI患者为研究对象,根据治疗方法分为观察组和对照组,每组82例。对照组患者给予经皮冠状动脉球囊扩张后支架植入术或直接支架植入术;观察组患者由引导管注入替罗非班10μg·kg-1,然后进行血栓抽吸,再植入支架。对2组患者PCI术后心肌梗死溶栓(TIMI)血流分级、PCI术后即刻造影结果、术后90 min心电图ST段回落率、血清肌酸激酶同工酶(CK-MB)峰值、术后1周左心室射血分数(LVEF)及术后出血率进行比较;所有患者术后随访1 a,观察主要心血管不良事件(MACE)发生情况。结果观察组患者无复流发生率、CK-MB峰值、校正的TIMI帧数显著低于对照组(P<0.05);观察组患者LVEF、ST段回落>50%所占比例显著高于对照组(P<0.05)。观察组患者术后TIMI分级显著优于对照组(P<0.05)。观察组和对照组患者术后轻度出血发生率分别为20.7%(17/82)、15.9%(13/82),2组患者轻度出血发生率比较差异无统计学意义(χ2=0.649,P>0.05)。术后1 a内,观察组和对照组患者MACE发生率分别为9.8%(8/82)、15.9%(13/82),2组患者术后1 a内MACE发生率比较差异无统计学意义(χ2=1.357,P>0.05)。结论替罗非班联合血栓抽吸可以显著改善STEMI患者PCI后心肌再灌注水平。
Objective To investigate the effect of tirofiban combined with thrombus aspiration on acute ST-elevation myocardial infarction(STEMI)patients undergoing percutaneous coronary intervention(PCI).Methods A total of 164 patients with acute STEMI who underwent PCI in the People′s Hospital of Jiaozuo from January 2016 to December 2017 were selected as the research subjects,and they were divided into observation group and control group according to therapeutic method,with 82 cases in each group.The patients in the control group were treated with stent implantation after percutaneous coronary balloon angioplasty or direct stent implantation.The patients in the observation group were injected with tirofiban 10μg·kg-1 through the guide tube,followed by thrombus aspiration and stent implantation.The thrombolysis in myocardial infarction(TIMI)classification after PCI,the results of angiography immediately after PCI,the ST-segment resolution rate at 90 minutes after PCI,the peak value of serum creatine kinase-MB(CK-MB),left ventricular ejection fraction(LVEF)at one week after operation and postoperative bleeding rate were compared between the two groups.All patients were followed up for one year to observe the major adverse cardiovascular events(MACE).Results The incidence of no reflow,the peak value of serum CK-MB and corrected TIMI frame count in the observation group were significantly lower than those in the control group(P<0.05).The LVEF and the proportion of patients with ST-segment resolution>50%in the observation group was significantly higher than that in the control group(P<0.05).The TIMI classification of patients in the observation group was significantly better than that in the control group(P<0.05).The incidence of postoperative mild bleeding in the observation group and the control group was 20.7%(17/82)and 15.9%(13/82),respectively.There was no significant difference in the incidence of mild bleeding between the two groups(χ2=0.649,P>0.05).Within one year after operation,the incidence of MACE in the observation group and the control group was 9.8%(8/82)and 15.9%(13/82),respectively.There was no significant difference in the incidence of MACE between the two groups(χ2=1.357,P>0.05).Conclusion Tirofiban combined with thrombus aspiration can significantly improve myocardial reperfusion in STEMI patients after PCI.
作者
刘翔宇
陈旭红
王娟
杨淑玲
尚伟
LIU Xiangyu;CHEN Xuhong;WANG Juan;YANG Shuling;SHANG Wei(Department of Cardiology,the People′s Hospital of Jiaozuo,Jiaozuo 454000,Henan Province,China)
出处
《新乡医学院学报》
CAS
2020年第9期877-880,共4页
Journal of Xinxiang Medical University
关键词
心肌梗死
替罗非班
血栓抽吸
经皮冠状动脉介入治疗
支架植入术
心肌缺血再灌注
myocardial infarction
tirofiban
thrombus aspiration
percutaneous coronary intervention
stent implantation
myocardial ischemia reperfusion
