目的：评价 ST 段抬高型心肌梗死（STEMI）患者急诊经皮冠状动脉介入治疗（PCI）中在梗死相关血管注射替罗非班的有效性和安全性。方法：我科2013年1月至2014年6月收治的30例 STEMI 患者作为替罗非班组，急诊 PCI 术中梗死相关血管内应用替罗非班500μg，植入支架后静脉滴注24h 替罗非班0.1μg·kg－1·min－1；同期的31例 STEMI 患者作为单纯支架组，急诊 PCI 术后直接植入支架。比较并分析两组支架植入后计算机辅助定量心肌灌注评分（QuBE 分值），住院期间及6个月随访左心室射血分数（LVEF）、主要不良心血管事件（MACE）发生率。结果：两组患者基线资料差异无统计学意义（P ＞0.05）。6个月后，与单纯支架组比较，替罗非班组QuBE 分值[（10.88±5.03）分比（14.70±6.69）分]及 LVEF [（57.19±4.59）％比（59.80±5.34）％]显著升高，而 MACE 发生率（35.5％比10.0％）显著降低（P 均＜0.05）。结论：ST 段抬高型心肌梗死患者急诊经皮冠状动脉介入治疗中在梗死相关血管应用替罗非班可以有效，安全地改善心肌微循环灌注水平，值得推广。%Objective:To evaluate the efficacy and safety of tirofiban infusion to infarct related vessels on patients with ST segment elevation myocardial infarction (STEMI)during emergency percutaneous coronary intervention (PCI).Methods:From Jan 2013 to Jun 2014,a total of 30 STEMI patients were enrolled as tirofiban group (tirofi-ban 500μg was infused to infarct related vessels during emergency PCI),and received intravenous drip of tirofiban 0.1 μg·kg-1 ·min-1 for 24h after stent implantation;another 31 STEMI patients were regarded as pure stenting group during the same period and they received direct stent implantation during emergency PCI.Computer-assisted Quantitative Blush Evaluator (QuBE)score,left ventricular ejection fraction (LVEF)during hospitalization and af-ter six-month follow-up and incidence rate of major adverse cardiovascular events were compared and analyzed be-tween two groups.Results:There were no significant difference in baseline data between two groups,P > 0.05. Compared with pure stenting group,after six months,there were significant rise in QuBE score [(10.88±5.03) scores vs.(14.70±6.69)scores]and LVEF [(57.19±4.59)% vs.(59.80±5.34)%],and significant reduction in incidence rate of MACE (35.5% vs.10.0%)in tirofiban group,P <0.05 all.Conclusion:Tirofiban application in infarct related vessels during emergency PCI in STEMI patients can effectively and safely improve myocardial micro-circulation perfusion level and it is worth extending.
展开▼
