中国医药
中國醫藥
중국의약
CHINA MEDICINE
2011年
10期
1168-1169
,共2页
心肌梗死%替罗非班%经皮冠状动脉介入治疗
心肌梗死%替囉非班%經皮冠狀動脈介入治療
심기경사%체라비반%경피관상동맥개입치료
Myocardial infarction%Tirofiban%Percutaneous coronary intervention
目的 评价急性心肌梗死(AMI)患者急诊经皮冠状动脉介入治疗(PCI)术中冠状动脉内注射替罗非班对梗死相关冠脉动脉血流的影响。方法 将98例AMI患者完全随机分为替罗非班组（46例）和常规治疗组（52例），对比2组PCI术后梗死相关冠脉动脉的心肌梗死溶栓试验(TIMI)分级、校正的TIMI计帧数，观察2组患者出血并发症发生率、住院期间和出院后6个月主要心血管事件(MACE)发生率。结果 PCI术后TIMI 3级血流获得率，替罗非班组(44/46，95.6％)高于常规治疗组(43/52，82.7％)，差异有统计学意义(P＜0.05)；校正的TIMI计帧数替罗非班组[(19.8±8.6)帧]低于常规治疗组[(28.3±5.8)帧]，差异有统计学意义(P＜0.01)。术后1周替罗非班组左心室射血分数[(54.2±6.7)％]高于常规治疗组[(49.6±8.1)％]，差异有统计学意义(P＜0.01)；出血并发症发生率高于常规治疗组，但差异无统计学意义(P＞0.05)。6个月内MACE发生率替罗非班组(2/46，4.3％)低于常规治疗组(9/52，17.3％)(P＜0.05)。结论 冠状动脉内注射替罗非班可明显改善AMI患者PCI术后的冠状动脉血流、心肌灌注及临床预后。
目的 評價急性心肌梗死(AMI)患者急診經皮冠狀動脈介入治療(PCI)術中冠狀動脈內註射替囉非班對梗死相關冠脈動脈血流的影響。方法 將98例AMI患者完全隨機分為替囉非班組（46例）和常規治療組（52例），對比2組PCI術後梗死相關冠脈動脈的心肌梗死溶栓試驗(TIMI)分級、校正的TIMI計幀數，觀察2組患者齣血併髮癥髮生率、住院期間和齣院後6箇月主要心血管事件(MACE)髮生率。結果 PCI術後TIMI 3級血流穫得率，替囉非班組(44/46，95.6％)高于常規治療組(43/52，82.7％)，差異有統計學意義(P＜0.05)；校正的TIMI計幀數替囉非班組[(19.8±8.6)幀]低于常規治療組[(28.3±5.8)幀]，差異有統計學意義(P＜0.01)。術後1週替囉非班組左心室射血分數[(54.2±6.7)％]高于常規治療組[(49.6±8.1)％]，差異有統計學意義(P＜0.01)；齣血併髮癥髮生率高于常規治療組，但差異無統計學意義(P＞0.05)。6箇月內MACE髮生率替囉非班組(2/46，4.3％)低于常規治療組(9/52，17.3％)(P＜0.05)。結論 冠狀動脈內註射替囉非班可明顯改善AMI患者PCI術後的冠狀動脈血流、心肌灌註及臨床預後。
목적 평개급성심기경사(AMI)환자급진경피관상동맥개입치료(PCI)술중관상동맥내주사체라비반대경사상관관맥동맥혈류적영향。방법 장98례AMI환자완전수궤분위체라비반조（46례）화상규치료조（52례），대비2조PCI술후경사상관관맥동맥적심기경사용전시험(TIMI)분급、교정적TIMI계정수，관찰2조환자출혈병발증발생솔、주원기간화출원후6개월주요심혈관사건(MACE)발생솔。결과 PCI술후TIMI 3급혈류획득솔，체라비반조(44/46，95.6％)고우상규치료조(43/52，82.7％)，차이유통계학의의(P＜0.05)；교정적TIMI계정수체라비반조[(19.8±8.6)정]저우상규치료조[(28.3±5.8)정]，차이유통계학의의(P＜0.01)。술후1주체라비반조좌심실사혈분수[(54.2±6.7)％]고우상규치료조[(49.6±8.1)％]，차이유통계학의의(P＜0.01)；출혈병발증발생솔고우상규치료조，단차이무통계학의의(P＞0.05)。6개월내MACE발생솔체라비반조(2/46，4.3％)저우상규치료조(9/52，17.3％)(P＜0.05)。결론 관상동맥내주사체라비반가명현개선AMI환자PCI술후적관상동맥혈류、심기관주급림상예후。
Objective To evaluate the effect of intracoronary injection of tirofiban on thrombolysis in myocardial infarction (TIMI) flow of infarct-related artery ( IRA ) in patients with acute myocardial infaction ( AMI )during emergency percutaneous coronary intervention (PCI). Methods Totally 98 STEMI patients were divided into tirofiban group (n =46) and routine group (n =52). The TIMI grade and corrected TIMI frame count(CTFC)following PCI operation were compared, and the bleeding condition as well as major adverse cardiac events ( MACE,including death, re-infarction and target vessel revascularization) in hospital and 6 months after discharge from hospital. Results There was a higher percentage of TIMI Ⅲ flow in tirofiban group following PCI (44/46,95.6％ vs 43/52,82.7％, P ＜0.05), and fewer TIMI frames as compared to the routine group (19.8 ± 8.6 frames vs 28.3 ±5.8 frames,P ＜ 0.01 ); The left ventricular ejection fraction (LVEF) one week after PCI was higher in tirofiban group(54.2 ±6.7％ vs 49.6 ±8.1％ ) ( P ＜0. 01 ) ; There was a higher prevalence in the complication of bleeding in tirofiban group but the difference had no statistical significance ( P ＞ 0.05 ). There was significant difference between the two groups in the occurrence of MACE within 6 month follow-up (2/46,4.35％ vs 9/52,17.30％ )(P ＜0.05). Conclusion Intracoronary injection of tirofiban during PCI in the intervention therapy for AMI can improve postoperative TIMI of IRA and myocardial perfusion as well as the clinical prognosis.
