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|

冠脉内小剂量替罗非班在急性STEMI急诊介入时应用观察

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2014年第2期
页码:
168-170
栏目:
临床研究
出版日期:
2014-01-20

文章信息/Info

Title:
Efficacy of low-dose intracoronary injection of tirofiban in patients with acute ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention
作者:
赵瑞革; 赵 月; 英海蓉; 王荣军; 戴路刚
(阜新市中心医院心内科，辽宁 阜新 123000)
Author(s):
ZHAO Rui-ge;  ZHAO Yue;  YING Hai-rong;  WANG Rong-jun;  DAI Lu-gang
(Department of Cardiology, Zhongxin Hospital, Fuxin 123000, Liaoning, China)
关键词:
替罗非班; 心肌梗死; 急性; ST段抬高型;  冠状动脉介入治疗
Keywords:
tirofiban;  acute ST-segment elevation myocardial infarction;  percutaneous coronary intervention
分类号:
R542.2
DOI:
-
文献标识码:
A
摘要:
目的:探讨急性ST段抬高型心肌梗死（STEMI)患者行急诊经皮冠状动脉介入治疗（PCI）时冠脉内小剂量应用替罗非班对介入治疗安全性和有效性。方法： 入选77例STEMI急诊介入治疗患者，全部患者入院后立即给予阿司匹林300 mg嚼服，氯吡格雷300 mg口服，随机分为替罗非班组（试药组，39例）和对照组（38例,未用替罗非班）。PCI术后梗死相关血管的心肌梗死溶栓（TIMI)血流分级、术后24 h ST段完全回落率、术后1周左心室射血分数(LVEF)、术后30 d主要心血管事件（死亡、再发心肌梗死、靶血管血运重建、反复心绞痛发作）及TIMI出血事件作为评价指标。结果： 术前两组患者基线资料（年龄、性别、危险因素）差异无统计学意义。术后即刻TIMI Ⅲ级血流获得率试药组明显高于对照组（P<0.05）。术后24h ST段完全回落率及1周时LVEF试药组明显高于对照组（均P<0.05,P<0.01）。术后30 d 随访两组主要心血管事件和主要出血事件的发生率差异均无统计学意义。结论： 对急性STEMI患者急诊介入治疗时，冠脉内应用小剂量替罗非班可以获得较好的即刻造影结果，且安全、有效。
Abstract:
AIM:To investigate the efficacy of early application of low-dose tirofiban in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). METHODS: A total of 77 STEMI patients were randomly divided into tirofiban group (n=39) and control group (n=38). PCI was performed in all patients within 12 h after onset of STEMI and patients were given an oral bolus dose of clopidogrel 300 mg and aspirin 300 mg before PCI. Tirofiban 2/3 (10 μg/kg bolus) was injected into the artery (IRA) during PCI and intravenously administered for 24h ［0.1μg/(kg·min)］ after PCI in tirofiban group. The thrombolysis in myocardial infarction (TIMI) flow grade, ST-segment complete recovery rate within 24 h, left ventricular ejection (LVEF), major adverse cardiac events (MACEs, including death, re-infarction, target vessel revascularization, recurrent angina pectoris) and TIMI bleeding events were recorded. RESULTS: Baseline data (including age, gender, risk factors and duration of hospitalization) of the two groups were comparable. Immediate TIMI flow grade after PCI in low-dose tirofiban group was significantly higher than in control group (all P<0.05). ST-segment complete recovery rate within 24 h and LVEF at 1 week in low-dose tirofiban group were also significantly higher than in control group (P<0.05, P<0.01). MACE rate in the two groups at 1 month was similar (P>0.05) and the incidence of major bleeding in the two groups was also similar. CONCLUSION: Intracoronary application of low-dose tirofiban during primary PCI is safe and effective for improving TIMI flow of IRA in patients with STEMI during primary PCI.

参考文献/References

[1]盐酸替罗非班多中心临床研究协作组.盐酸替罗非班对急性冠脉综合征的疗效和安全性评价[J].临床心血管病杂志,2006,22(4):220-222.
[2]TIMI Study Group.The thrombolysis in myocardial infarction(TIMI)trial Phase I findings[J].N Engl J Med,1985,312(14):932-936.
[3]Zemyer U,Schroder K,Wegscheider K,et al.ST resolution in a single electrocardiographic lead:a simple and accurate predictor of cardiac mortality in patients with fibrinolytic therapy for acute ST-elevation myocardial infarction[J].Am Heart J,2005,149(1):91-97.
[4]Bovill EG,Terrin ML,Stump DC,et al.Hemogghagic events during therapy with recombinant tissue-type plasminogen activator, heparin, and aspirin for acute myocardial infarction.Result of the Thrombolysis in Myocardial Infarction. Result of the Thrombolysis in Myocardial Infraction(TIMI)Phase Ⅱ Trial[J].Ann Intern Med,1991,115(4):256-265.
[5]Razakjr OA,Tan HC,Yip WL,et al.Predictors of bleeding complications and thrombocytopenia with the use of abciximab during percutaneous coronary intervention[J].J Interv Cardiol,2005,18(1):33-37.
[6]张之瀛,耿 涛,张建刚,等.急性心肌梗死患者血小板活化程度及其临床意义[J].疑难病杂志,2008,7(12):744-745.
[7]张成森,孟昭燕,尹作民,等.急诊经皮冠状动脉介入中血栓抽吸对急性ST段抬高心肌梗死预后的影响[J].中国医药,2010,5(10):790.
[8]沈 杰,沈卫峰.替罗非班在急性冠脉综合征介入治疗中的应用[J].国际心血管病杂志,2006,33(2):156-159.
[9]Wamholtz A,Ostad MA,Heitzer T,et al.Effect of tirofiban on percutaneous coronary intervention-induced endothelial dysfunction in patients with stable coronary artery disease[J].Am J Cardiol,2005, 95(1):20-23.
[10]Eikelboom JW,Mehta SR,Anand SS,et al.Adverse impact of bleeding on prognosis in patients with acute coronary syndromes[J].Circulation,2006,114(7):774-782.

备注/Memo

备注/Memo:
收稿日期：2013-08-10.
作者简介：赵瑞革，主任医师，硕士Email：ruigezhao@sina.com
更新日期/Last Update: 2014-01-16