广州医学院学报
廣州醫學院學報
엄주의학원학보
ACADEMIC JOURNAL OF GUANGZHOU MEDICAL COLLEGE
2013年
6期
37-40
,共4页
急性ST段抬高型心肌梗死%替罗非班%血栓抽吸导管%经皮冠状动脉介入治疗
急性ST段抬高型心肌梗死%替囉非班%血栓抽吸導管%經皮冠狀動脈介入治療
급성ST단태고형심기경사%체라비반%혈전추흡도관%경피관상동맥개입치료
acute ST segment elevation myocardial infarction%tirofiban%thrombus aspiration catheter%percutaneous coronary intervention
目的:研究替罗非班联合血栓抽吸导管预处理对急性ST段抬高型心肌梗死( STEMI)患者即刻或择期经皮冠状动脉介入( PCI)治疗的临床疗效和安全性的影响。方法:纳入102例经急诊冠状动脉造影显示罪犯血管前向血流TIMI 0级,且伴有明显血栓负荷影像的STEMI患者。应用替罗非班联合血栓抽吸导管预处理至前向血流恢复TIMI 3级后,随机分为即刻PCI治疗组( n=52)及择期(7~10 d后) PCI治疗组(n=50)。比较两组患者冠脉支架植入情况,PCI治疗中慢血流或无复流事件发生率,住院期间主要心血管事件发生率及PCI治疗后4周左室射血分数( LVEF)。结果:择期PCI治疗组冠脉支架植入成功率显著高于即刻PCI治疗组(100% vs 86.54%, P<0.05),且使用支架数量较少;即刻PCI治疗组治疗中慢血流或无复流事件的发生率为9.62%,择期 PCI 治疗组无1例发生,差异有统计学意义( P <0.05);即刻PCI治疗组患者住院期间主要心血管事件发生率为7.69%,择期PCI治疗组为0,差异有统计学意义(P<0.05);PCI治疗后4周两组患者LVEF比较差异无统计学意义(P>0.05)。结论:经替罗非班联合血栓抽吸导管预处理达TIMI 3级血流的STEMI患者行后续择期PCI治疗比即刻PCI治疗有更好的临床疗效,且安全性明显提高。
目的:研究替囉非班聯閤血栓抽吸導管預處理對急性ST段抬高型心肌梗死( STEMI)患者即刻或擇期經皮冠狀動脈介入( PCI)治療的臨床療效和安全性的影響。方法:納入102例經急診冠狀動脈造影顯示罪犯血管前嚮血流TIMI 0級,且伴有明顯血栓負荷影像的STEMI患者。應用替囉非班聯閤血栓抽吸導管預處理至前嚮血流恢複TIMI 3級後,隨機分為即刻PCI治療組( n=52)及擇期(7~10 d後) PCI治療組(n=50)。比較兩組患者冠脈支架植入情況,PCI治療中慢血流或無複流事件髮生率,住院期間主要心血管事件髮生率及PCI治療後4週左室射血分數( LVEF)。結果:擇期PCI治療組冠脈支架植入成功率顯著高于即刻PCI治療組(100% vs 86.54%, P<0.05),且使用支架數量較少;即刻PCI治療組治療中慢血流或無複流事件的髮生率為9.62%,擇期 PCI 治療組無1例髮生,差異有統計學意義( P <0.05);即刻PCI治療組患者住院期間主要心血管事件髮生率為7.69%,擇期PCI治療組為0,差異有統計學意義(P<0.05);PCI治療後4週兩組患者LVEF比較差異無統計學意義(P>0.05)。結論:經替囉非班聯閤血栓抽吸導管預處理達TIMI 3級血流的STEMI患者行後續擇期PCI治療比即刻PCI治療有更好的臨床療效,且安全性明顯提高。
목적:연구체라비반연합혈전추흡도관예처리대급성ST단태고형심기경사( STEMI)환자즉각혹택기경피관상동맥개입( PCI)치료적림상료효화안전성적영향。방법:납입102례경급진관상동맥조영현시죄범혈관전향혈류TIMI 0급,차반유명현혈전부하영상적STEMI환자。응용체라비반연합혈전추흡도관예처리지전향혈류회복TIMI 3급후,수궤분위즉각PCI치료조( n=52)급택기(7~10 d후) PCI치료조(n=50)。비교량조환자관맥지가식입정황,PCI치료중만혈류혹무복류사건발생솔,주원기간주요심혈관사건발생솔급PCI치료후4주좌실사혈분수( LVEF)。결과:택기PCI치료조관맥지가식입성공솔현저고우즉각PCI치료조(100% vs 86.54%, P<0.05),차사용지가수량교소;즉각PCI치료조치료중만혈류혹무복류사건적발생솔위9.62%,택기 PCI 치료조무1례발생,차이유통계학의의( P <0.05);즉각PCI치료조환자주원기간주요심혈관사건발생솔위7.69%,택기PCI치료조위0,차이유통계학의의(P<0.05);PCI치료후4주량조환자LVEF비교차이무통계학의의(P>0.05)。결론:경체라비반연합혈전추흡도관예처리체TIMI 3급혈류적STEMI환자행후속택기PCI치료비즉각PCI치료유경호적림상료효,차안전성명현제고。
Objective:To study the efficacy and safety of preconditioning of tirofiban and thrombus aspiration catheter upon immediate or selective percutaneous coronary intervention ( PCI ) in patients with ST segment elevation myocardial infarction ( STEMI) . Methods: We included 102 patients with STEMI displaying TIMI grade 0 forward flow of the culprit vessel and marked thrombus load images in the coronary angiography. Following preconditioning with tirofiban and thrombus aspiration catheter that drove the forward flow to recover to TIMI grade 3, patients were randomly allocated to immediate (n=52) and selective (7 ~10 days thereafter) PCI treatment group ( n=50 ) . This entailed the comparison on the need for coronary stent implantation, the incidence rate of slow blood flow or no reflow event during PCI, the incidence of major cardiovascular events during hospitalization and the left ventricular ejection fraction (LVEF) at week 4. Results: The success rate of coronary stent implantation and the consumption of coronary stents in selective PCI treatment group was markedly higher and reduced than those in immediate PCI treatment group (100% vs 86. 54%, P<0. 05). The incidence rate of slow blood flow or no reflow event in the immediate PCI treatment group was markedly higher than in selective PCI treatment group (9. 62% vs. 0. 0%, P<0. 05). A similar pattern applied to the incidence rate of major cardiovascular events during hospitalization (7. 69% vs 0, P<0. 05). There was no significant difference in LVEF at week 4 (P >0. 05). Conclusion: Compared with immediate PCI treatment, the selective PCI treatment is superior in terms of efficacy and safety in STEMI patients with blood flow of TIMI grade 3 or less following preconditioning with tirofiban and thrombus aspiration catheter.