冠状动脉内注射替罗非班对急性ST段抬高型心肌梗死罪犯血管自发再通患者的疗效分析

发布时间：2018-10-15 18:08

【摘要】：目的:研究冠状动脉(冠脉)内注射替罗非班治疗在急性ST段抬高型心肌梗死(STEMI)病变血管再通患者急诊PCI应用中的临床疗效。方法:选取火箭军总医院2012-1-2016-01收治的STEMI患者,经冠脉造影证实病变血管再通并行急诊PCI患者191例,分为替罗非班组(108例)及对照组(83例)。替罗非班组患者在常规PCI操作基础上,给予冠脉内注射替罗非班10μg/kg。比较两组患者病变相关血管(IRA)的TIMI血流分级和手术成功率,进一步随访观察2组患者30d及12个月心血管不良事件发生率(MACE)及出血事件,并通过超声心动图评估心脏功能及结构。结果:对于IRA再通的STEMI患者,冠脉内注射替罗非班可以显著促进PCI术后IRA血流恢复,减少术后早期及晚期心力衰竭的发生,不增加出血事件,减少平均住院天数。心脏超声结果发现,冠脉内注射替罗非班显著提高患者远期心脏功能。结论:对于IRA自发再通的STEMI患者,直接冠脉内注射替罗非班能够提高心肌再灌注,增加心脏功能,改善患者预后,安全可行。
[Abstract]:Objective: to study the clinical effect of intracoronary injection of tirofiban in patients with acute ST segment elevation myocardial infarction (ST) undergoing (STEMI) revascularization. Methods: 191 patients with STEMI, confirmed by coronary angiography, were divided into two groups: tirofiban group (n = 108) and control group (n = 83). Patients in the tirofiban group were given 10 渭 g / kg of tirofiban by intracoronary injection on the basis of routine PCI procedures. The TIMI blood flow classification and surgical success rate of (IRA) were compared between the two groups. The incidence of cardiovascular adverse events (MACE) and bleeding events were observed at 30 days and 12 months in the two groups. The cardiac function and structure were evaluated by echocardiography. Results: for STEMI patients with IRA recanalization, intracoronary injection of tirofiban significantly promoted the recovery of IRA blood flow after PCI, reduced the incidence of early and late postoperative heart failure, did not increase bleeding events, and reduced the average hospital stay. The results of echocardiography showed that intracoronary injection of tirofiban significantly improved long-term cardiac function. Conclusion: for STEMI patients with spontaneous recanalization of IRA, direct intracoronary injection of tirofiban can improve myocardial reperfusion, increase cardiac function, improve prognosis and be safe and feasible.
【作者单位】：中国人民解放军火箭军总医院心血管内科;
【分类号】：R542.22

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