目的:在急诊经皮冠状动脉介入治疗(PCI)过程中,观察对有大量血栓负荷的急性ST段抬高型心肌梗死(STEMI)患者直接冠状动脉内注射替罗非班的疗效和安全性.方法:104例有大量血栓负荷的急性ST段抬高型心肌梗死患者,随机分为冠脉内注入替罗非班组56例和对照组48例,比较两组间的冠状动脉血流、ST段回落率、住院期间和30 d时主要不良心血管事件(MACE)及出血等并发症.结果:冠脉内注入替罗非班组的梗死相关血管TIMI 3级血流比例增多(89.3%vs 85.4%,P<O.05)、框格计数法计算的梗死相关血管血流量增加[(1.68±0.23)mL/s vs (1.42±O.31)mL/8,P<0.05]、心电图ST段回落幅度变大[(64.3±7.8)% vs (48.6±6.5)%,P<0.05)]、住院期间和30 d时的MACE事件发生率降低(10.7% vs 18.8%,P<0.05),与对照组比较差异有统计学意义,而出血并发症和血小板减少症发生率两组间差异无统计学意义.结论:急诊PCI时,对血栓负荷重的急性STEMI冠状动脉内注射替罗非班治疗方法简单、安全和行之有效.
Efficacy and safety of intracoronary tirofiban bolus administration in the treatment of acute ST-elevation myocardial infarction with large thrombus burden during primary percutaneous coronary intervention
AIM: To study the efficacy and safety of intracoronary tirofiban bolus administration in the treatment of acute ST-elevation myocardial infarction (STEMI) with large thrombus burden during primary percutaneous coronary intervention (PCI). METHODS: A total of 104 consecutive STEMI patients with large thrombus burden detected by emergent coronary angiography were randomly divided into 2 groups; intraeoronary tirofiban group(56 cases) and control group(48 cases). Clinical events and angiographic features between 2 groups before and after PCI were analyzed. RESULTS: TIMI3 flow(89.3% vs 85.4%, P ＜ 0.05), the volume of coronary blood flow obtained in corrected TIMI frame count [(1.68 ± 0.23) mL/s vs (1.42 ± 0.31) mL/s, P ＜ 0.05], ST segment resolution magnitude [(64.3 ± 7.8 )% vs (48.6 ± 6.5)%, P ＜ 0.05] were higher in the intracoronary tiroiiban group than in the control group. The combined incidence of MACE during follow-up was significantly lower in the intraeoronary tirofiban group compared with control group (10.7% vs 18.8%, P ＜ 0.05). Bleeding complications and thrombocytopenia were similar between 2 groups. CONCLUSION: Intracoronary bolus application of tirofiban is simple, safety and utility in patients with STEMI undergoing primary PCI.
NETL
NSTL
万方数据
维普
