早期使用替罗非班及抽吸导管对减少AMI急诊PCI无复流的疗效观察

摘要

Objective To study the effect of reducing no-reflow after PCI treatment by early using Tirofiban and suction catheter in AMI patients .Methods 76 cases of patients were divided into group A (38 cases) and group B(38 cases) .The group A began to use Tirofiban with suction catheter to aspiration after coronary guidewire entering ,the suction were used in group B when the thrombus burden became exacerbation after balloon dilation .In addition ,chosen 38 cases of AMI patients treated with Tirofiban af-ter balloon dilation as group C .The influence of different treatment options to no-reflow and slow blood flow ,cardiovascular adverse events and the incidence of bleeding were observed .Results Group A compared with other two groups ,the no-reflow and slow flow rate had statistically significant differences (P< 0 .05) ,but there was no statistically significant differencebetween group B and group C(P>0 .05) .After three different surgical treatments ,the incidence of bleeding complications had no significant difference (P>0 .05 .The occurrence of adverse cardiovascular events had statistically significant between A group and C (P<0 .05) ,but there was no statistically significant difference between group B and group C (P<0 .05) .Conclusion Three kinds of treatment all have certain effect to reduce no-reflow in emergency PCI of AMI ,but early use of tirofiban with suction catheter in treatment of emergen-cy treatment has great clinical significance to reduce no-reflow .This study provides an effective treatment plan to reduce no-reflow in PCI for AMI .%目的：研究早期使用替罗非班及抽吸导管对减少急性心肌梗死（AMI）急诊经皮冠状动脉介入治疗（PCI）无复流的疗效。方法将76例入选患者分为A组（38例）和B组（38例），A组在导丝进入后即冠状动脉使用替罗非班血栓导管抽吸，B组于球囊扩张后发现血栓负荷重再应用替罗非班血栓导管抽吸。另选同期38例用药盐酸替罗非班后再做球囊扩张的A M I患者38例作为C组。观察不同治疗方案对无复流和慢血流、心血管不良事件、出血性并发症等的发生情况的影响。结果 A组与其他两组无复流和慢血流情况比较差异有统计学意义（P＜0．05）；C组和B组比较差异无统计学意义（P＞0．05）。3组在经过不同的手术处理后，其出血性并发症发生情况差异无统计学意义（P＞0．05）。A组和B、C组的心血管不良事件发生情况差异有统计学意义（P＜0．05），但C组和B组比较差异无统计学意义（P＞0．05）。结论3种治疗方案对减少AMI急诊 PCI无复流均有一定的作用，但早期使用替罗非班及抽吸导管在对减少AMI急诊PCI无复流有显著的临床意义。该研究为减少AMI急诊PCI无复流提供了一种有效的治疗方案。