摘要
目的本研究旨在剖析应用替罗非班在急性ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者急诊经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗后对冠状动脉微循环的影响及临床疗效。方法抽选2015年4月至2016年4月在开封市第二人民医院接受急诊PCI治疗的STEMI患者100例,均为血栓负荷重的患者。将入选患者以随机、双盲抽取数字的方法分为两组:治疗组(50例)向冠状动脉内注射替罗非班,随后行PCI治疗;对照组(50例)急诊行PCI治疗。观察并比较两组介入前后心肌梗死溶栓试验(thrombolysis in myocardial infarction,TIMI)、心肌着色分级评价(mycardial Blush grades,MBG or Blush分级)、校正TIMI帧数(corrected TIMI frame count,CTFC)、住院期间及出院30 d内主要心血管事件(major adverse cardiovascular events,MACE)发生率、住院期间出血事件发生情况。结果两组基线资料比较,差异无统计学意义(P>0.05)。治疗组MBG血流3级患者比例明显高于对照组,CTFC明显多于对照组,差异有统计学意义(P<0.05)。结论在血栓负荷重的STEMI患者的急诊PCI治疗中应用替罗非班能获得较好的心肌微循环再灌注,可以明显改善患者的临床预后。
Objectives To analyze the effects of tirofiban on coronary microcirculation and clinical efficacy in patients with acute ST-segment elevation myocardial infarction(STEMI)undergoing primary coronary intervention(PCI).Methods Totally100patients with acute STEMI were selected in Kaifeng City Second People′s Hospital from Febru?ary2015to February2016.The patients were with heavy load thrombosis and received emergency PCI.The patients enrolled in this experiment were divided into two groups by a randomized,double-blind method.Tirofiban was injected into coronary artery in patients of control group(50cases)and then the patients were treated with primary PCI.Patients of control group were treated with primary PCI only.A variety of indicators were compared and observed,including thrombolysis in myocardial infarction(TIMI)flow grade before and after interventional thrombolysis;myocar?dial Blush grade(MBG)evaluation criteria(MBG or Blush grade);corrected TIMI frame count(CTFC);major adverse cardiovascular events(MACE)rate during hospitalization and30days out of hospital;incidence of bleeding events during hospitalization.Results There was no significant differences of basline data between the two groupos(P>0.05).Percentage of patients with MBG blood flow grade3was obviously higher in experimental group than in control group;CTFC was more in experimental group than in control group(P<0.05).Conclusions Among the STEMI patients with heavy load thrombosis,injection of tirofiban in the coronary arteries can get a better level of myocardial tissue reperfu?sion and a better clinical prognosis.
作者
潘庆丽
霍本良
王立旗
PAN Qing-li;HUO Ben-liang;WANG Li-qi(Kaifeng City Second People′s Hospital,Kaifeng,Henan 475002,China)
出处
《岭南心血管病杂志》
2017年第6期662-664,688,共4页
South China Journal of Cardiovascular Diseases
关键词
心肌梗死
微循环功能障碍
血管成形术
经腔
经皮冠状动脉
替罗非班
acute myocardial infarction
dysfunction of microcirculation
percutaneous coronary intervention
tirofiban
