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国产替罗非班对急性心肌梗死冠状动脉 介入治疗术后心肌灌注的影响(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2008年第5期
页码:
605-607
栏目:
临床研究
出版日期:
2008-10-20

文章信息/Info

Title:
Effect of tirofiban on myocardial perfusion in patients with acute myocardial infarction treated by primary percutaneous coronary intervention
作者:
韩玮; 马春梅; 刘惠亮; 罗建平; 杨胜利; 刘英
武警总医院心内科，北京 100039
Author(s):
HAN Wei;  MA Chunmei;  LIU Huiliang;  LUO Jianping;  YANG Shengli;  LIU Ying
Department of Cardiology, General Hospital of Chinese Armed Police Forces, Beijing 100039, China
关键词:
替罗非班; 心肌梗死; 急性; 冠状动脉介入治疗; 无复流; 心肌灌注
Keywords:
tirofiban;  acute myocardial infarction;  primary percutaneous coronary intervention;  myocardial perfusion;  no reflow
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的 评价替罗非班在急性心肌梗死（AMI）直接冠状动脉介入治疗（PCI）中的有效性和安全性。方法 行直接PCI治疗的AMI患者，分为预先应用替罗非班组（40例）和对照组（32例），比较两组患者的无复流发生率、心肌灌注分级（TMPG）和出血并发症。结果 两组患者均成功完成PCI操作，试验组有4例（10%）出现无复流或慢复流现象，对照组共有8例（25%）出现无复流现象，试验组无复流发生率有低于对照组的趋势，但未达到显著水平，替罗非班组的TMPG Ⅲ级比例高于对照组，但未达到统计学显著水平，两组主要不良事件无显著性差异。两组患者总的出血并发症相似，均无严重出血并发症。结论 国产替罗非班能降低AMI直接PCI 时无复流现象，改善冠状动脉血流，且不增加严重出血并发症。
Abstract:
AIM To investigate the effect and safety of Chinamade tirofiban in patients with acute myocardial infarction treated by primary percutaneous coronary intervention. METHODS Seventytwo AMI patients were included in the study, who received either Tirofiban before the index procedure (n=40) or just PCI alone (n=32). The no reflow rate, TIMI myocardial perfusion grade (TMPG), major adverse cardiovascular events (MACE) and bleeding complications were compared between the two groups. RESULTS PCI were successfully performed in all patients. The no reflow rate in Tirofiban group was not significantly lower than that in control group (10% versus 25%) and the percentage of TMPG Ⅲ grade in Tirofiban group was not significantly higher than that in control group (45% versus 25%). MACE during hospitalization and bleeding complications had no significant differences between the two groups. CONCLUSION Tirofiban, a GlycoproteinⅡb/Ⅲa receptor blocker, administrated in primary PCI of AMI patients can safely reduce no reflow rate and improve myocardial perfusion.

参考文献/References

［1］ Gibson CM, Cannon CP, Murphy SA, et al. Relationship of the TIMI myocardial perfusion grades, flow grades, frame count, and percutaneous coronary intervention to longterm outcomes after thrombolytic administration in acute myocardial infarction［J］. Circulation, 2002, 105(5):1909-1913.

［2］ Morrow DA, Sabatine MS, Antman EM, et al. Usefulness of tirofiban among patients treated without percutaneous coronary intervention (TIMI high risk patients in PRISMPLUS) ［J］. Am J Cardiol, 2004, 94(6):774-776.

［3］ Valgimigli M, Percoco G, Barbieri D, et al. The additive value of tirofiban administered with the highdose bolus in the prevention of ischemic complications during highrisk coronary angioplasty: the ADVANCE Trial［J］. J Am Coll Cardiol, 2004, 44(1):14-19.

［4］ Montalescot G, Borentain M, Payot L, et al. Early vs late administration of glycoprotein IIb/IIIa inhibitors in primary percutaneous coronary intervention of acute STsegment elevation myocardial infarction: a metaanalysis［J］. JAMA, 2004, 292(3):362-366.

［5］ Huynh T, Piazza N, DiBattiste PM, et al. Analysis of bleeding complications associated with glycoprotein Ⅱb/Ⅲa receptors blockade in patients with highrisk acute coronary syndromes: insights from the PRISMPLUS study ［J］. Int J Cardiol, 2005, 100(1):73-78.

备注/Memo

备注/Memo:
收稿日期：2006-12-28.作者简介：韩玮，主治医师，博士Email：hanwei1973@tom.com
更新日期/Last Update: