摘要
目的探讨冠状动脉内注射血小板Ⅱb／Ⅲa受体拮抗剂对sT段抬高型急性心肌梗死（AMI）急诊经皮冠状动脉介入治疗（PCI）中慢或无复流心肌梗死溶栓治疗（TIMI）血流的影响。方法选取2013年1月-2015年10月本院就诊的42例AMI后PCI患者，以术中有无出现慢或无复流现象为依据将患者分为两组．术中出现慢或无复流现象为研究组（n=12），未出现慢或无复流现象为对照组（n=30），对于研究组给予其常规硝酸甘油治疗，对无效者再冠状动脉内注射替罗非班，术后替罗非班静脉维持；对照组行常规治疗。术中两组患者肝素用量6000-10000U。比较两组PCI术后TIMI血流情况、不同时间ST段完全回落率、不良反应发生情况。结果研究组梗死相关动脉（IRA）PCI术后TIMI血流等级情况与对照组比较，差异无统计学意义（P〉0．05）。两组患者PCI术后sT段回落情况比较，差异有统计学意义（P〈0．05）。两组术后均无心血管事件发生，研究组发生尿潜血阳性3例，经减用肝素后好转。结论冠状动脉内注射血小板Ⅱb／Ⅲa受体拮抗剂治疗AMI急诊PCI术中慢或无复流安全有效，临床价值显著，可在临床上广泛推广应用。
Objective To investigate the effect of intracoronary injection of platelet Ⅱ b/Ⅲ a receptor antagonist on ST elevation acute myocardial infarction （AM1） undergoing percutaneous coronary intervention （PCI） in slow or no reflow throm- bolysis in myocardial infarction （TIMI） blood flow.Methods 42 cases of PCI patients in the hospital from January 2013 to October 2015 during the period of AMI were divided into two groups according to whether there was slow or no reflow phenomenon during the operation,slow or no reflow phenomenon occurred in the study group （n=12）,and there was no slow or no fellow phenomenon as the control group （n=30）,patients in the study group were treated with conventional Nitroglycerin,patients with inefficient were treated with intravenous injection of Tirofiban,and Tirofiban after surgery was intravenously maintained;patients in the control group were treated with conventional treatment.The dosage of hep- arin was 6000 to 10000 U in the two groups.The TIMI blood flow,ST segment complete drop rate at different times and adverse reactions were compared between two groups after PCI.Results Infarction related artery （IRA） in the study group after PCI blood flow of TIMI grade,compared with that in the control group,had no significant difference （P〉0.05）. ST segment drop after PCI between two groups had obvious difference （P〈0.05）.Patients in two groups had no cardio- vascular events,3 patients with urine occult blood positive in the research group had improved after reducing heparin. Conclusion Intracoronary injection of platelet Ⅱ b/Ⅲa receptor antagonist in the treatment of AMI emergency PCVwas safe and effective,and its clinical value was significant,and it can be widely used in clinical practice.
出处
《中国当代医药》
2016年第30期41-43,共3页
China Modern Medicine
基金
江西省景德镇市科技计划项目(sf20133105)
关键词
替罗非班
急性心肌梗死
经皮冠状动脉介入治疗
心肌梗死溶栓治疗
血流分级
Tirofiban
Acute myocardial infarction
Percutaneous coronary intervention
Thrombolysis in myocardial in-farction
Blood flow classification
