摘要
目的探究血栓抽吸及替罗非班预处理罪犯血管后延迟支架植入术治疗急性心肌梗死的效果。方法前瞻性选取2018年5月至2020年5月上海市徐汇区中心医院收治的60例急性ST段抬高型心肌梗死(STEMI)患者作为研究对象,所有患者均行罪犯血管血栓抽吸及替罗非班预处理治疗,血流达到TIMI 3级后,按照随机数字表法分为观察组(延迟PCI术)与对照组(直接PCI术),各30例。比较2组患者PCI术后心肌灌注情况、心功能指标以及心血管不良事件发生率。结果观察组患者TIMI 3级血流占比(93.3%)明显高于对照组(73.3%),无复流比率(0)明显低于对照组(16.7%),TFC帧数[(22.61±3.25)帧]明显低于对照组[(25.65±3.17)帧],差异均有统计学意义(P<0.05)。观察组患者左心室射血分数(LVEF)[(58.49±3.26)%]显著高于对照组[(48.34±3.31)%],差异有统计学意义(P<0.05),但左室舒张末容积(LVEDD)以及左室收缩末容积(LVESD)比较,差异无统计学意义(P>0.05);观察组患者心血管不良事件发生率(10.0%)低于对照组(36.7%),差异有统计学意义(P<0.05)。结论血栓抽吸及替罗非班预处理罪犯血管后延迟支架植入术,有利于改善术后TIMI血流及心功能,减少心血管事件的发生,可在临床广泛推广。
Objective To explore the effects of delayed stent implantation after thrombus aspiration and tirofiban preconditioning the criminal's blood vessel in the treatment of acute myocardial infarction.Methods From May 2018 to May 2020,60 patients with acute ST-elevation myocardial infarction(STEMI)in Shanghai Xuhui District Central Hospital were selected as the research objects.All patients were treated with criminal vascular thrombus aspiration and tirofiban pretreatment.After the blood flow reached TIMI level 3,they were divided into observation group(delayed PCI operation)and control group(direct PCI operation)according to the random number table method,with 30 cases in each group.The myocardial perfusion,cardiac function indexes and the incidence of adverse cardiovascular events were compared between the two groups of patients after PCI.Results The proportion of TIMI grade 3 blood flow in the observation group(93.3%)was significantly higher than that of the control group(73.3%),the no-reflow rate(0)was significantly lower than the control group(16.7%),the number of TFC frames[(22.61±3.25)frames]was significantly lower than that of the control group[(25.65±3.17)frames],the difference was statistically significant(P<0.05).The left ventricular ejection fraction(LVEF)of the observation group[(58.49±3.26)%]was significantly higher than that of the control group[(48.34±3.31)%],the difference was statistically significant(P<0.05),but the difference between left ventricular end diastolic volume(LVEDD),left ventricular end systolic volume(LVESD)was not statistically significant(P>0.05);the incidence of adverse cardiovascular events in the observation group(10.0%)was lower than that in the control group(36.7%),and the difference was statistically significant(P<0.05).Conclusion Thrombus aspiration and tirofiban preconditioning the criminal's blood vessel and delaying stent implantation are beneficial to improve postoperative TIMI blood flow and cardiac function,reduce the occurrence of cardiovascular events,and can be widely promoted in clinical practice.
作者
曹佳齐
丁跃有
郑宏超
CAO Jia-qi;DING Yue-you;ZHENG Hong-chao(Department of Cardiology,Shanghai Xuhui District Central Hospital,Shanghai 200031,China)
出处
《临床和实验医学杂志》
2021年第13期1395-1398,共4页
Journal of Clinical and Experimental Medicine
基金
国家自然科学基金面上项目(编号:81570229)。
关键词
急性心肌梗死
血栓抽吸
替罗非班
罪犯血管
延迟支架植入术
Acute myocardial infarction
Thrombus aspiration
Tirofiban
Criminal vessel
Delayed stent implantation
