阿托伐他汀联合替罗非班在ST段抬高型急性心肌梗死患者PCI治疗中的应用

发布时间：2018-08-13 17:53

【摘要】：目的观察阿托伐他汀联合替罗非班在ST段抬高型急性心肌梗死(STEMI)患者经皮冠状动脉介入(PCI)治疗中的应用效果。方法将存在无复流高风险的STEMI患者172例随机分为观察组94例和对照组78例,两组均行急诊PCI治疗,观察组术前口服阿托伐他汀80 mg、术中冠状动脉内注射替罗非班,对照组冠状动脉内注射尿激酶;术后两组均口服阿托伐他汀40 mg/d,应用7 d后减为20 mg/d,连用6个月。观察两组无复流发生情况、术后72 h内心肌灌注情况,统计术后6个月主要不良心脏事件(MACE)发生率。结果观察组、对照组术后无复流发生率分别为3.19%(3/94)、26.92%(21/78),组间差异具有统计学意义(P0.05);观察组术后72 h内心肌灌注速度和心肌血流量均明显大于对照组(P均0.05);术后随访6个月,观察组MACE发生率明显低于对照组(P0.05)。结论大剂量阿托伐他汀联合替罗非班用于STEMI患者PCI治疗,可降低术后无复流发生率,增加心肌组织灌注,改善预后。
[Abstract]:Objective to observe the effect of Atto vastatin combined with tirofiban on percutaneous coronary intervention (PCI) in patients with St segment elevation acute myocardial infarction (St segment elevation acute myocardial infarction). Methods 172 STEMI patients with high risk of no reflow were randomly divided into the observation group (n = 94) and the control group (n = 78). The patients in both groups were treated with emergency PCI. The patients in the observation group were given Atto vastatin 80 mg before operation and tirofiban was injected intraoperatively into the coronary artery. In the control group, urokinase was injected into the coronary artery, and Atto vastatin 40 mg / d was taken orally in both groups. After 7 days, it was reduced to 20 mg / d for 6 months. No reflow occurred in the two groups, myocardial perfusion was observed within 72 hours after operation, and the incidence of major adverse cardiac events (MACE) at 6 months after operation was counted. Results in the observation group, the incidence of no reflow was 3.19% (3 / 94) or 26.92% (21 / 78) in the control group, the difference between the two groups was statistically significant (P0.05), the myocardial perfusion velocity and myocardial blood flow in the observation group were significantly higher than those in the control group within 72 hours after operation (P 0.05). The incidence of MACE in the observation group was significantly lower than that in the control group (P0.05). Conclusion High dose of Atto vastatin combined with tirofiban in the treatment of PCI in patients with STEMI can reduce the incidence of no reflow, increase myocardial perfusion and improve prognosis.
【作者单位】：罗定市人民医院;
【分类号】：R542.22

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