摘要
目的:评价替罗非班在大量血栓负荷的急性ST段抬高型心肌梗死(STEMI)患者急诊经皮冠脉介入治疗(PCI)中的作用。方法:根据随机数字表法,152例接受直接PCI介入治疗的STEMI患者被随机均分为常规治疗组(接受常规治疗)和替罗非班组(在常规治疗组基础上接受替罗非班治疗)。比较两组治疗前后N末端B型利钠肽前体(NT-proBNP)水平和左室射血分数(LVEF),治疗后TIMI血流3级率、ST抬高段下降≥50%率和肌酸激酶同工酶(CK-MB)达峰时间,以及术后3个月内的主要不良心血管事件(MACE)发生率。结果:与常规治疗组比较,替罗非班组治疗后NT-proBNP水平[(1563.65±420.63)pg/ml比(528.36±236.17)pg/ml]降低更显著,LVEF[(54.68±2.63)%比(58.82±3.62)%]升高更显著,P<0.01或<0.05。与常规治疗组比较,替罗非班组治疗后TIMI 3级率(73.68%比94.74%)、ST抬高段下降≥50%率(68.42%比92.11%)显著升高,CKMB达峰时间[(10.96±2.86)h比(8.62±2.13)h]和3个月内MACE总发生率(65.79%比19.74%)显著降低(P<0.05或<0.01)。结论:替罗非班可显著改善大量血栓负荷的STEMI患者的心功能,降低主要不良心血管事件发生率,值得临床推广。
Objective：To evaluate the effect of tirofiban during emergency percutaneous coronary intervention（PCI）in patients with acute ST elevation myocardial infarction（STEMI）and massive thrombus burden.Methods：According to random number table,a total of 152 STEMI patients undergoing direct PCI were randomly and equally divided into routine treatment group（received routine treatment）and tirofiban group（received additional tirofiban treatment based on routine treatment group）.Level of N terminal pro brain natriuretic peptide（NT-proBNP）and left ventricular ejection fraction（LVEF）before and after treatment,TIMI flow grade 3 rate,elevated ST segment depression ≥50% rate and creatine kinase isoenzyme MB（CK-MB）time to peak after treatment,and incidence rate of major adverse cardiovascular events（MACE）within three months after PCI were compared between two groups.Results：Compared with routine treatment group,after treatment,there was significant reduction in NT-proBNP level[（1563.65±420.63）pg/ml vs.（528.36±236.17）pg/ml]and significant rise in LVEF[（54.68±2.63）% vs.（58.82±3.62）%]in tirofiban group,P〈0.01,0.05.Compared with routine treatment group after treatment,there were significant rise in TIMI flow grade 3rate（73.68% vs.94.74%）and elevated ST segment depression ≥50% rate（68.42% vs.92.11%）,and significant reduction in CK-MB time to peak[（10.96±2.86）h vs.（8.62±2.13）h]and incidence rate of total MACE within three months（65.79% vs.19.74%）in tirofiban group,P〈0.05 or 0.01.Conclusion：Tirofiban can significantly improve cardiac function,and reduce incidence rate of MACE in STEMI patients with massive thrombus burden,which is worth extending.
作者
戴美凤
陆传新
赵宏坤
朱永武
蒋逸风
沈彬
DAI Mei-feng LU Chuan-xin ZHAO Hong-kun ZHU Yong-wu JIANG Yi-feng SHEN Bin(Department of Cardiolo- gy, 411st Hospital of Chinese PLA, Shanghai, 200081, China)
出处
《心血管康复医学杂志》
CAS
2016年第5期516-519,共4页
Chinese Journal of Cardiovascular Rehabilitation Medicine
