CAJ | 학술논문

目的探讨在老年急性ST段抬高型心肌梗死患者中经抽吸导管推注替罗非班对无复流的疗效及对患者出血并发症的影响. 方法连续入选65岁及以上的老年急性ST段抬高心肌梗死(STEMI)接受急诊介入治疗的患者120例,数字抽签随机分为替罗非班组和对照组各60例,两组患者均首先进行血栓抽吸治疗,替罗非班组患者在抽吸治疗后首先经抽吸导管推注替罗非班10μg/kg,后行经皮冠状动脉介入术(PCI),对照组患者抽吸后直接行PCI,观察两组患者无复流的发生率和出血并发症的发生率. 结果替罗非班组PCI术后无复流的发生率10.0％(6/60),对照组25.0％(15/60),差异有统计学意义(x2=4.68,P=0.031).两组患者均未发生中重度出血并发症,替罗非班组轻度出血16例(26.7％),对照组13例(21.7％),两组比较差异无统计学意义(x2=0.19,P=0.522). 结论经抽吸导管推注替罗非班可降低老年急性STEMI患者无复流的发生率,同时不增加出血并发症.
목적 탐토재노년급성ST단태고형심기경사환자중경추흡도관추주체라비반대무복류적료효급대환자출혈병발증적영향. 방법 련속입선65세급이상적노년급성ST단태고심기경사(STEMI)접수급진개입치료적환자120례,수자추첨수궤분위체라비반조화대조조각60례,량조환자균수선진행혈전추흡치료,체라비반조환자재추흡치료후수선경추흡도관추주체라비반10μg/kg,후행경피관상동맥개입술(PCI),대조조환자추흡후직접행PCI,관찰량조환자무복류적발생솔화출혈병발증적발생솔. 결과 체라비반조PCI술후무복류적발생솔10.0％(6/60),대조조25.0％(15/60),차이유통계학의의(x2=4.68,P=0.031).량조환자균미발생중중도출혈병발증,체라비반조경도출혈16례(26.7％),대조조13례(21.7％),량조비교차이무통계학의의(x2=0.19,P=0.522). 결론 경추흡도관추주체라비반가강저노년급성STEMI환자무복류적발생솔,동시불증가출혈병발증.
Objective To evaluate the effect of early intracoronary injection of tirofiban via aspiration catheter on myocardial no-reflow in elderly patients with acute ST-segment elevation myocardial infarction (STEMI).Methods 120 consecutive patients over 65 years old with AMI undergoing primary percutaneous coronary intervention (PCI) were randomized into two groups.In tirofiban group (n=60),thrombus aspiration and intracoronary tirofiban bolus (10 μg/kg prior to the first balloon inflation) via aspiration catheter were performed.In control group (n=60),thrombus aspiration was followed by primary PCI.The incidence of no-reflow and bleeding were assessed in the two groups.Results The moderate to severe bleeding (TIMI bleeding criteria) did not occur in the two groups,there's no significant difference between two groups in the incidence of minor bleeding [26.7％(16 cases) vs.21.7％ (13 cases),x2 =0.19,P=0.522].The incidence of myocardial noreflow was significantly lower in tirofiban group than in the control group [10.0％ (6/60) vs.25.0％ (15/60),x2 =4.68,P=0.031].Conclusions The intracoronary injection of tirofiban via aspiration catheter may significantly reduce the incidence of myocardial no-reflow in patients with STEMI without increasing bleeding complications.