摘要
目的观察血小板膜糖蛋白(GP)Ⅱb/Ⅲa受体拮抗剂替罗非班在70岁以上急性心肌梗死(AMI)患者急诊冠脉介入治疗(PCI)围术期应用的疗效及安全性。方法61例70岁以上AMI患者经急诊冠脉造影示TIMI0-1级,分为替罗非班组和对照组。替罗非班组30例,PCI术前开始应用替罗非班,持续泵入至术后36～48h。对照组31例,治疗同常规PCI。观察两组冠脉复流、30d再梗死和死亡情况及并发出血情况。结果替罗非班组急诊PCI术后TIMI3级血流发生率100%,无慢复流、无复流现象发生,30d内无再梗死及死亡发生,与对照组比较差别有统计学意义(P<0.05);两组患者的小出血率间差别无统计学意义(P>0.05)。结论在70岁以上AMI患者急诊PCI围术期应用替罗非班既可开通冠脉,又可改善冠脉血流,减少术后再梗死,达到真正意义上挽救心肌的目的,但应注意对消化道出血的防治。
Objective To observe the therapeutic effect and safety of perioperative application of tirofiban, a platelet glycoprotein （GP） Ⅱ b/Ⅲ a receptor antagonist, in percutaneous coronary intervention （PCI） of over - 70 - year - old patients with acute myocardial infarction （AMI）. Methods Sixty - one over - 70 - year - old AMI patients, whose emergency coronary angiography showed 0 - 1 - grade TIMI, were divided into tirofiban group （ n = 30） and control group （ n = 31 ）. Tirofiban was used before PCI and continuously pumped in until 36 - 48 h after PCI in tirofiban group, and the control group were treatd with conventional PCI. We observed coronary blood reflow, 30 - day re - infarction, death and situation of complicated bleeding. Results All of the tirofiban group recovered with grade 3 TIMI coronary blood flow, and no slow reflow and non - reflow were observed ; 30 - day re - infarction and mortality were reduced significantly as compared with the control group. Conclusion In over -70 -year- old AMI patients, application of tirofiban in PCI perioperation can not only open coronary artery, but also improve coronary blood flow and reduce postoperative re - infarction, to reach significantly the goal of saving cardiac. But control of alimentary tract hemorrhage should be paid special attention to.
出处
《中国全科医学》
CAS
CSCD
2008年第12期1030-1032,共3页
Chinese General Practice
关键词
急性心肌梗死
急诊冠脉介入治疗
围术期
替罗非班
Acute myocardial infarction
Emergency percutaneous coronary intervention
Perioperative period
Tirofiban
