摘要
目的:探讨药物洗脱支架与替罗非班联合用于急诊PCI治疗ST段抬高型心肌梗塞(STEMI)的安全性和有效性。方法:选择2005年1月至2007年9月STEMI患者254例,均于12h内行急诊PCI治疗,随机分为三组,分别给予置入金属裸支架(BMS)、药物洗脱支架(DES)、药物洗脱支架+替罗非班治疗。随诊观察6～12个月,比较三组主要心脏不良事件(MACE,包括死亡率、再发心肌梗塞、靶病变重建等)、支架内血栓形成和无复流现象发生的差异。结果:154例患者中,47例置入金属裸支架,49例置入药物洗脱支架,58例置入药物洗脱支架+替罗非班治疗。随访期间,MACE、支架内再狭窄率、靶病变重建率,DES组分别为:6.1%、4.1%、2.0%,BMS组分别为:21.3%、17.0%、12.8%,两组相比差异均有显著性(P<0.05～<0.01),支架内血栓形成两组差异无显著性。DES组+替罗非班组与DES组相比MACE和无复流现象显著减少(P<0.05),其余指标差异无显著性(P>0.05)。结论:在STEMI的急诊PCI中,DES具有更好的有效性和安全性,与替罗非班联合应用可以明显降低心脏不良事件的发生和无复流现象。
Objective： To study the effectiveness of treatment of acute myocardial infarction by tirofiban combined with drug-eluting stent. Methods： Choosing 154 STENI cases from January to September in 2005, who accepted emergency PCI treatment within 12 h, were randomly divided into three groups, the first group used bare metal stent （BMS）, the second group used the drug-eluting stent （DES）, the third group used DES＋tirofiban. Follow up time was 6%12months after treatment. Results： The 47 cases of patients treated with BMS implantation, 49 cases with DES implantation and 58 cases with DES-Ftirofiban in 154 cases. During the follow up period, the overall adverse cardiac events, the stent re-stenosis rate, the target lesion rebuilding rate： in DES group were as follows.. 6.1%, 4. 1%, 2.0%, BMS group were as follows： 21.3%, 17.0% 12.8%, compared between two groups the difference was significant （P〈0. 05-〈0. 01）. The difference of thrombosis in stent was not significant （P〉0.05）. Compared with DES groups, the incidence of cardiac adverse events and no-flow phenomenon significantly decreased （P〈0.05） in DES＋ tirofiban group hined Conclusion： In STEMI with emergency PCI, DES has better efficacy and safety. The treatment of DES corntirofiban can significantly reduce the incidence of cardiac adverse events and no-flow phenomenon.
出处
《心血管康复医学杂志》
CAS
2008年第5期496-498,共3页
Chinese Journal of Cardiovascular Rehabilitation Medicine
关键词
急性心肌梗塞
血管成形术
经腔
经皮冠状动脉
替罗非班
Acute myocardial infarction
Angioplasty, transluminal, percutaneous coronary
Tirofiban
