术前与术中使用替罗非班对急性ST段抬高心肌梗死急诊介入治疗慢血流的比较及安全性

中国临床药理学与治疗学 ›› 2014, Vol. 19 ›› Issue (11): 1268-1271.

术前与术中使用替罗非班对急性ST段抬高心肌梗死急诊介入治疗慢血流的比较及安全性

周勇¹, 黄松群², 徐飞¹

¹ 安徽宿州市立医院心血管内科,宿州 234000,安徽;
² 第二军医大学附属长海医院心血管内科,上海 200433

收稿日期:2013-09-23 修回日期:2014-10-29 出版日期:2014-11-26 发布日期:2014-12-09
作者简介:周勇,男,硕士,主治医师,研究方向:临床心血管药理。Tel: 18955755502 E-mail: zhouyong770915@163.com。黄松群,并列第一作者,男,硕士,主治医师,研究方向:心血管介入治疗。Tel: 13585588854 E-mail: 513599680@qq.com

Efficacy on slow bleeding and safety of using tirofiban before and during emergency PCI in patients with acute ST-segment elevation myocardial infarction

ZHOU Yong¹, HUANG Song-qun², XU Fei¹

¹ Department of Cardiology, Suzhou Municipal Hospital, Suzhou 234000, Anhui, China;
² Department of Cardiology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China

Received:2013-09-23 Revised:2014-10-29 Online:2014-11-26 Published:2014-12-09

摘要/Abstract

摘要： 目的探讨术前与术中应用替罗非班对急性ST段抬高心肌梗死经皮冠状动脉介入(PCI)治疗中慢血流的比较及安全性。方法将90例急性ST段抬高心肌梗死患者随机分为替罗非班术前组(30例)、替罗非班术中组(30例)和对照组(30例)。比较三组患者梗死相关血管PCI治后即刻TIMI血流、校正TIMI帧数计数(CTFC)、90 min ST段回落百分比、出血和血小板减少的发生率。结果与对照组相比,替罗非班术前组及替罗非班术中组PCI后慢血流发生率显著降低(P<0.05),90 min 内ST段回落百分比提高;与替罗非班术中组相比,替罗非班术前组PCI后慢血流发生率降低更加显著(P<0.05);两组患者均未出现住院期间死亡及急性血栓形成,出血并发症比较差异无统计学意义(P>0.05)。结论 PCI术前早期应用替罗非班能更好地改善急性ST段抬高心肌梗死患者PCI后梗死相关血管的慢血流的发生,临床应用安全有效。

关键词: 替罗非班, 急性ST段抬高心肌梗死, 急诊介入治疗

Abstract: AIM: To compare the curative effect and safety of tirofiban before and during emergency PCI in patients with ST-segment elevated myocardial infarction(STEM). METHODS: Ninety patients with STEMI undergoing emergency PCI were randomized into three groups:tirofiban before PCI group (TBP group) (n=30,with early administration of tirofiban immediately in emergency department),tirofiban during PCI group (TDP group) (n=30,with administration of tirofiban in during PCI) and control group(n=30). TIMI flow,corrected TIMI frame count(CTFC),and ST segment resolution 90 min after PCI of three groups were compared. The incidences of bleeding complications and thrombocytopenia were registered to assess the safety.RESULTS: Compared with the control group,the CTFC and blood flow velocity in TBP and TDP groups were significantly improved (P<0.05), and the proportion of ST segment resolution was significantly higher. Compared with TDP group, the CTFC and blood flow velocity were significantly improved in TBP group (P<0.05). However, no significant difference was observed in major adverse cardiac events and bleeding in three groups.CONCLUSION: Early administration of tirofiban before emergency PCI improves myocardial reperfusion and reduces occurrence of slow-flow in patients undergoing primary PCI.

Key words: tirofiban, acute ST segment elevation myocardial infarction, emergency percutaneous coronary intervention

中图分类号:

R542.2

周勇, 黄松群, 徐飞. 术前与术中使用替罗非班对急性ST段抬高心肌梗死急诊介入治疗慢血流的比较及安全性[J]. 中国临床药理学与治疗学, 2014, 19(11): 1268-1271.

ZHOU Yong, HUANG Song-qun, XU Fei. Efficacy on slow bleeding and safety of using tirofiban before and during emergency PCI in patients with acute ST-segment elevation myocardial infarction[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2014, 19(11): 1268-1271.

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