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|本期目录/Table of Contents|

GP Ⅱb/Ⅲa受体拮抗剂对STEMI患者急诊PCI治疗中TIMI血流的影响

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2015年第5期
页码:
556-559
栏目:
临床研究
出版日期:
2015-05-05

文章信息/Info

Title:
Analysis of effects of IIb/IIIa receptor antagonist on the flow condition of emergency patients in the treatment of PCI TIMI STEMI
作者:
江甲子; 刘 志
（中国医科大学附属第一医院急诊科，辽宁 沈阳 110001）
Author(s):
JIANG Jia-zi;  LIU Zhi
(Department of Emergency, First Hospital of China Medical University, Shenyang, 110001, Liaoning, China)
关键词:
心肌梗死; ST段抬高型; 急性; 急诊经皮冠状动脉介入治疗; Ⅱb/Ⅲa受体拮抗剂; 盐酸替罗非班; 急性心肌梗死溶栓试验血流
Keywords:
ST segment elevation acute myocardial infarction;  percutaneous coronary intervention;  IIb/IIIa receptor antagonist;  tirofiban;  TIMI flow
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的 探讨ST段抬高型急性心肌梗死（STEMI）患者急诊经皮冠状动脉介入（PCI）治疗中运用血小板糖蛋白(GP)Ⅱb/Ⅲa受体拮抗剂盐酸替罗非班对患者梗死相关血管血流的影响作用。方法 按照就诊顺序将92例STEMI患者分为试药组和对照组各46例，试药组患者行PCI前1~3 h冠脉内应用替罗非班，对照组直接行PCI，比较两组患者PCI中梗死相关血管的急性心肌梗死溶栓试验(TIMI)血流情况、主要心血管不良事件及预后情况。结果 PCI术前，研究组的TIMI血流分级Ⅲ级（33%）、Ⅱ级（43%）高于对照组的Ⅲ级和Ⅱ级构成比，试药组的TIMI血流分布显著优于对照组（P<0.05）。PCI术后，试药组的TIMI血流分级Ⅲ级（91%）、Ⅱ级（9%）与对照组的Ⅲ级（85%）、Ⅱ级（15%）分布比较接近，两组PCI术后TIMI血流分级比较差异不显著。PCI术前与术后，试药组的TIMI心肌再灌注(TMP)血流分级分布均显著的优于对照组（P<0.05）。PCI术后住院期间，两组患者的主要心血管不良事件发生率、术后左室射血分数值，血小板计数减少情况比较差异均不显著。结论 急诊PCI术前常规应用替罗非班对改善术前梗死血管血流、心肌灌注、术后心肌灌注均有显著作用。
Abstract:
AIM Discussion on ST segment elevation acute myocardial infarction (STEMI) patients in emergency percutaneous coronary intervention (PCI) in the use of IIb/IIIa receptor antagonist tirofiban influence for patients with infarction related artery blood flow. METHODS According to the order of treatment, 92 patients with STEMI were divided into study group and controlgroup with 46 cases in each group, the study group patients before PCI 1-3 h intracoronary use of tirofiban, controls directly for PCI, TIMI, vascular blood flow of infarction were compared between groups in PCI adverse events and prognosis and were stratified according to age group comparison. RESULTS Preoperative PCI, TIMI blood flow study group of grade 3 (32.61%) and grade 2 (43.48%) was higher than control group grade 3 and grade 2 constituent ratio. Distribution of blood flow in the study group was superior to that of TIMI in the control group (P<0.05). After PCI, TIMI blood flow study group of grade 3 (91.30%), grade 2 (8.70%) and control group grade 3 (84.78%), grade 2 (15.22%) distribution is relatively close. PCI operation in two groups after TIMI flow grade did not show significant difference. Before and after PCI, the study group of TMP flow grade distribution are significantly better than the control group (P<0.05). During PCI hospitalization, adverse events of two groups of patients and the incidence of postoperative complications and LVEF value comparing the differences between PLT reduction was not significant. Distribution of TIMI blood flow grading difference before and after operation in the >65-year-old group and <65 year-old group in PCI group was not significant. Distribution of blood flow and classification of TMP is less than or equal to the >65-year-old group of patients and <65-year-old group were significantly different (P<0.05). CONCLUSION Routine preoperative application of tirofiban in emergency PCI improved preoperative infarction vascular blood flow and myocardial perfusion. Myocardial reperfusion after operation showed a significant effect.

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备注/Memo

备注/Memo:
收稿日期：2014-10-23.
通讯作者：刘志,主任医师，主要从事呼吸系统疾病诊疗研究 Email：liujunqiang195907@163.com
作者简介：江甲子，住院医师，硕士生 Email：2796658813@qq.com
更新日期/Last Update: 2015-04-28