血栓抽吸术联合替罗非班对STEMI患者的疗效分析

摘要

目的：观察行急诊经皮冠状动脉介入治疗（PCI）的急性ST段抬高型心肌梗死（STEMI）患者予以联合应用血栓抽吸和大剂量替罗非班的临床疗效及预后。方法78例STEMI患者随机分为试验组（30例）与对照组（48例），术中试验组序贯给予血栓抽吸和大剂量替罗非班冠状动脉内推注处理，对照组仅予以大剂量替罗非班冠状动脉内推注处理，经处理后植入支架。观察术后冠状动脉血流TIMI分级、24 h ST 段完全回落率、第7天的左心室射血分数（ LVEF ）、1个月的主要心血管事件（ MACE ）。结果两组患者年龄、性别、吸烟史、饮酒史、高血压病史、术前LVEF差异均无统计学意义（P＞0.05）；试验组术后血流TIMI 3级获得率、24 h ST段完全回落率及第7天LVEF的结果均高于对照组，差异有统计学意义（ P＜0.05），术后1个月MACE的发生率无统计学差异（ P＞0.05）。结论 STEMI患者急诊PCI术中予以联合应用血栓抽吸术及大剂量替罗非班，可显著增加心肌供血，改善心功能及愈后。%Objective Observe the effect of thrombus aspiration combined with Tirofiban in coronary artery for acute ST segment ele -vation myocardial infarction in primary PCI .Methods Select 78 cases of patients with STEMI ,the experimental group uses two methods ,the control group uses large does Tirofiban ,then Stent placement .observe the coronary blood flow TIMI grading ,24 h ST complete drop ratoin ,7 d LVEF,1 month MACE.Results the Differences of Age,sex,smoking,drinking,history of arterial hypertension of two groups ,had no statisti-cal significance(P>0.05),The experimental group were higher than the control group in the result of TIMI 3 get blood flow rate,24 hST complete drop rate,7 d LVEF(P<0.05),Differences of 1 month MACE had no statistical significance (P>0.05).Conclusion Thrombus aspiration combined with Tirofiban in coronary artery for acute ST segment elevation myocardial infarction in primary PCI can Increase myocar -dial blood supply ,Improve cardiac function and after operation .