DIVER CE血栓抽吸导管联合替罗非班在急诊冠状动脉介入治疗中的应用

摘要

Objective To observe the curative effect and safety of DIVER CE thrombus aspiration catheters combined with tirofiban ( the receptor antagonist of platelet glycoprotein Ⅱb/Ⅲa ) during emergency percutaneous coronary intervention ( PCI ) in the patients with acute myocardial infarction ( AMI ). Methods The AMI patients ( n =60 ) accorded with the condition of emergency PCI were chosen and randomly divided into the experimental group ( n =30 ) given treatment of DIVER CE thrombus aspiration and tirofiban followed by PCI, and control group ( n = 30 ) given PCI by routine method. The incidence rate of major adverse cardiac events ( MACE ), LVEF and LVEDD after PCI for one week, TIMI flow changes before and after PCI and bleeding complications were compared between two groups during hospitalization. Results The total incidence rate of MACE was lower in the experimental group ( 3.3％ ) than that in the control group ( 13.3％ ) and the difference was significant ( P ＜0.05 ). The incidence rate of bleeding complications was not different between two groups ( P ＞ 0.05 ). The proportion of post-PCI grade Ⅲ TIMI and LVEF value before discharge in the experimental group were superior to those in the control group, and the difference was statistically significant ( all P ＜ 0.05 ), but the difference in LVEDD was not statistically significant between two groups. Conclusion DIVER CE thrombus aspiration catheters combined with tirofiban used in emergency PCI in AMI patients is safe and effective.%目的 观察急性心肌梗死(AMI)患者行急诊冠状动脉介入治疗(PCI)过程中联合应用DIVER CE血栓抽吸导管与血小板糖蛋白Ⅱb/Ⅲa受体拮抗剂替罗非班的临床疗效与安全性.方法 选择符合急诊PCI治疗条件的急性心肌梗死患者共60例,随机分为两组,试验组(n=30)患者给予DIVER CE血栓抽吸与替罗非班;对照组(n=30)患者按常规方法完成PCI术.比较两组患者住院期间主要心脏不良事件(MACE)的发生率,术后1周左室射血分数(LVEF)和左室舒张末期内径(LVEDD),手术前后的心肌梗死TIMI血流变化和出血性并发症发生率.结果 试验组患者住院期间总MACE发生率(3.3%)低于对照组(13.3%),两组间差异有显著性意义(P＜0.05);两组出血发生率无明显差异(P＞0.05).术后TIMI Ⅲ级比例与出院前LVEF值试验组略优于对照组,两组间的差异有统计学意义(P均＜0.05),但两组间LVEDD的差异无统计学意义.结论 在急性心肌梗死急诊PCI中应用DIVER CE血栓抽吸导管联合替罗非班治疗安全有效.