我们的网站为什么显示成这样？

可能因为您的浏览器不支持样式，您可以更新您的浏览器到最新版本，以获取对此功能的支持，访问下面的网站，获取关于浏览器的信息：

|本期目录/Table of Contents|

静脉溶栓联合替罗非班治疗急性ST段抬高型心肌梗死的效果

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2009年第6期
页码:
851-853,856
栏目:
临床研究
出版日期:
2009-11-05

文章信息/Info

Title:
Effects of tirofiban combined with urokinase in patients with acute ST-elevation myocardial infarction
作者:
马林业1; 骆金玺1; 魏琦1; 高传玉2
1.许昌市人民医院心内科，河南 许昌 461000；2.河南省人民医院心内科，河南 郑州450003
Author(s):
MA Lin-ye1;  LUO Jin-xi1;  WEI Qi1;  GAO Chuan-yu2
1.Department of Cardiology, Xuchang City People’s Hospital, Xuchang 461000, Henan, China; 2.Department of Cardiology, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan, China
关键词:
心肌梗死; 急性; ST段抬高; 尿激酶; 静脉溶栓; 替罗非班
Keywords:
acute myocardial infarction;  urokinase;  tirofiban;  prognosis
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的: 观察急性ST段抬高型心肌梗死(STEAMI)早期尿激酶静脉溶栓联合国产替罗非班治疗的疗效及安全性。方法: 2007年6月~2008年7月收治STEAMI患者60例，均符合WHO的诊断标准且≤3 h能接受溶栓治疗并在1周内完成冠状动脉造影（CAG），分成常规组(24例)和联合组(36例)。常规组用尿激酶150万U 30 min内静脉滴入。联合组在溶栓同时应用替罗非班。两组均配合低分子肝素皮下注射，记录心电图、超声心动图、心肌酶谱、活化部分凝血酶时间(APTT)、CAG，观察间接和直接冠脉再通指标、院内心脏事件、药物不良反应，评价近期疗效和安全性。结果: 联合组在冠状动脉间接指标再通率、直接指标再通率、溶栓后胸痛缓解时间、CK-MB峰值、CK-MB达峰值时间、1周后左心室收缩末期直径(LVESD)、1周后左心室舒张末期直径(LVEDD)、平均住院天数、院内紧急血运重建、院内再发心肌梗死和常规组比较两组无统计学意义，但在心电图ST段回落≥50%、1周后梗死相关血管（IRA）血流≥TIMIⅡ级、1周后后心肌TMPⅢ级、1周后左室射血分数(LVEF)值、院内发生不稳定型心绞痛、院内心脏事件方面两组有统计学意义（P<0.05）。不良反应方面联合组溶栓24 h后凝血酶原时间延长有统计学意义（P<0.05），在血小板计数和出血事件方面两组无统计学意义。结论: ≤3 h的STEAMI在早期静脉溶栓的同时联合应用国产盐酸替罗非班在改善梗死相关血管TIMI血流和心肌灌注方面优于常规溶栓组，并未增加出血风险。
Abstract:
AIM: To study the efficacy and safety of tirofiban combined with urokinase in patients with acute ST-elevation myocardial infarction (STEMI). METHODS: Sixty consecutive STEMI patients were randomly divided into two groups: group A treated with urokinase 2 (n=24) and group B treated with tirofiban combined with urokinase (n=36). The efficacy of the treatment was compared between groups. RESULTS: Cardiovascular event rates, unstable angina, left ventricular ejection fraction and TMP in group B were better than those in group A (13.9% vs. 54.2%, 8.3% vs. 29.2%, 62.7±3.9 vs. 56.3±6.4, 72.2% vs. 41.7%, P<0.05). No significant difference was found in severe hemorrhage between groups. CONCLUSION: Tirofiban, a GPIIb/IIIa antagonist, is safe and effective when administered in combination with urokinase in STEMI patients.

参考文献/References

［1］ Schomig A, Ndrepepa G, Mehilli J, et al. Therapy-dependent influence of time-to-treatment interval on myocardial salvage in patientas with acute myocardial infarction treated with coronary artery stenting or thrombolysi［J］. Circulation, 2003, 108(9):1084-1088.

［2］ Gibson CM, Pride YB, Buros JL, et al. Association of impaired thrombolysis in myocardial infarction myocardial perfusion grade with ventricular tachycardia and ventricular fibrillation following fibrinolytic therapy for ST-segment elevation myocardial infarction［J］. J Am Coll Cardiol, 2008, 51(5):546-551.

［3］ Bovill EG, Terrin ML, Stump DC, et al. Hemogghagic events during therpy with recombinant tissue-type plasminogen activator, heparin, and aspirin for acute myocardial infarction. Result of the Thrombolysis in Myocardial Infarction(TIMI) Phase Ⅱ Trial［J］. Ann Inter Med, 1991, 115(4):256-265.

［4］ Zijlstra F, Patel A, Jones M, et al. For the PTCA collaboration. Clinical characteristics and outcomes of patients with early (2h),intermediate(2-4h)and late(4h) presentation treated by primary coronary angioplasty or thrombolytic therapy for acute myocardial infarction［J］. Eur Heart J, 2002, 23(7):550-557.

［5］ Brodie BR, Weintraub RA, Stuckey TD, et al. Outcomes of direct coronary angioplasty for acute myocardial infarction in candidates and non-candidates for thrombolytic therapy［J］. AM J Cardiol, 1991, 67(1):7-12.

［6］ Bonnefoy E, Lapostolle F, Leizorovicz A, et al. Primary angioplasty versus prehospital fibrinolysis in acute myocardial infarction: a randomized study［J］. Lancet, 2002, 360(9336):825-829.

［7］ Gupta M, Chang WC, Van de Werf F, et al. International differences in in-hospital revascularization and outcomes following acute myocardial infarction:a multilevel analysis of patients in ASSENT-2［J］. J Eur Heart, 2003, 24(18):1640-1650.

［8］ Verheugt FW.Lyse now, stent later: the grace of GRACIA［J］. Lancet, 2004, 364(9439):1014-1015.

［9］ Heitzer T, Oilmann I, Koke K, et al. Platelet glycoprotein Ⅱb/Ⅲa receptor blockade improves vascular nitric oxide bioavailability in patients with coronary artery disease［J］. Circulation, 2003, 108(5):536-541.

［10］Liron M. Tirofiban in unstable coronary disease［J］. N Engl J Med, 1998, 339(16):1163-1165.

备注/Memo

备注/Memo:
收稿日期：2008-9-22.通讯作者：马林业，主治医师，硕士，主要从事冠心病研究Email:lyma756@126.com
更新日期/Last Update: 2009-09-30