摘要
目的探讨银杏达莫注射液对急性心肌梗死(AMI)患者行直接经皮冠状动脉成形术(PCI)后心肌灌注和临床预后的影响。方法 74例行直接PCI的AMI患者随机分为银杏达莫联用替罗非班组(研究组,37例)与单用替罗非班组(对照组,37例),分析术后心肌灌注情况,住院期间和随访6个月时的心血管事件发生情况。结果两组间PCI术后心肌梗死溶栓试验(TIMI)血流分级的差异无统计学意义(P>0.05)。研究组术后校正的TIMI计帧法(CTFC)为(24.4±6.3)帧,显著少于对照组的(28.1±15.4)帧(P=0.032)。研究组术后ST回落<50%有3例(8.1%),显著低于对照组的8例(21.6%,P<0.05)。研究组住院期间2例死亡,与对照组(6例)的差异无统计学意义(P=0.10)。两组随访6个月时的心血管事件发生率的差异均无统计学意义(P值均>0.05)。结论与单用替非罗斑比较,银杏达莫联合替非罗斑能有效地改善心肌血流灌注,在临床上有一定的应用前景,但需要更大规模的临床试验来证实其临床效果。
Objective To discuss of the effect of Ginkgo dipyridamole injection on myocardial perfusion and clinical prognosis of patients with acute myocardial infarction（AMI）after primary percutaneous coronary intervention（PCI）.Methods Seventy-four AMI patients treated by PCI were randomized into Ginkgo dipyridolum Tirofiban group（n=37）and Tirofiban group（n=37）.The post-PCI myocardial perfusion was analyzed and the cardiac events were observed during hospitalization and within 6 months after discharge.Results The thrombolysis in myocardial infarction（TIMI）flow grades were not significantly different between the two groups after PCI（P0.05）.The corrected TIMI frame count（CTFC）in Ginkgo dipyridamole ＋ Tirofiban group was significantly lower than that in Tirofiban group（24.4±6.3 vs.28.1±15.4,P=0.032）.Three（8.1%）patients in Ginkgo dipyridamole ＋ Tirofiban group had their postoperative ST dropped by less than 50%,which was significantly less than that in the Tirofiban group（8[21.6%],P0.05）.There were 2 deaths in Ginkgo dipyridamole ＋ Tirofiban group and 6 deaths in Tirofiban group during hospitalization（P=0.10）.The incidences of cardiac events were not significantly different between the two groups during the 6 months of follow-up（P0.05）.Conclusions Compared to Tirofiban alone,Ginkgo dipyridolum combined with Tirofiban can effectively improve myocardial perfusion,showing a clinical application potential,but the exact effect needs to be verified by more large-scale clinical trials.
出处
《上海医学》
CAS
CSCD
北大核心
2010年第10期930-933,共4页
Shanghai Medical Journal
基金
上海市医学重点专科心血管内科资助(05-Ⅱ026)
上海中医药大学附属普陀医院院级课题(2007Z047A)
关键词
银杏达莫
直接经皮冠状动脉成形术
急性心肌梗死
心肌灌注
Ginkgo dipyridolum
Primary percutaneous coronary intervention
Acute myocardial infarction
Myocardial perfusion
