CAJ | 학술논문

目的：探讨急诊经皮冠状动脉介入治疗(PCI)术前静脉应用替罗非班联合术中冠脉内小剂量给药的疗效和安全性。方法102例行急诊PCI的急性ST段抬高型心肌梗死(STEMI)患者，随机分为研究组(52例)和对照组(50例)。研究组术前应用替罗非班，对照组术前未应用。比较两组梗死相关动脉(IRA)自发再通率， PCI术中慢血流、无复流发生率，术后7 d主要心血管事件(MACE)及出血事件发生率。结果研究组介入治疗前冠脉造影提示IRA自发再通率高于对照组，术中慢血流、无复流的发生率要低于对照组，组间比较，差异有统计学意义(P<0.05)；研究组术后7 d的MACE事件的发生率低于对照组，但差异无统计学意义(P>0.05)。两组均未发生严重出血事件。结论急诊PCI术前静脉应用替罗非班联合术中冠脉内小剂量给药的方法在IRA血流改善方面优于术中冠脉内给药，同时不增加出血风险。
목적：탐토급진경피관상동맥개입치료(PCI)술전정맥응용체라비반연합술중관맥내소제량급약적료효화안전성。방법102례행급진PCI적급성ST단태고형심기경사(STEMI)환자，수궤분위연구조(52례)화대조조(50례)。연구조술전응용체라비반，대조조술전미응용。비교량조경사상관동맥(IRA)자발재통솔， PCI술중만혈류、무복류발생솔，술후7 d주요심혈관사건(MACE)급출혈사건발생솔。결과연구조개입치료전관맥조영제시IRA자발재통솔고우대조조，술중만혈류、무복류적발생솔요저우대조조，조간비교，차이유통계학의의(P<0.05)；연구조술후7 d적MACE사건적발생솔저우대조조，단차이무통계학의의(P>0.05)。량조균미발생엄중출혈사건。결론급진PCI술전정맥응용체라비반연합술중관맥내소제량급약적방법재IRA혈류개선방면우우술중관맥내급약，동시불증가출혈풍험。
Objective To investigate the curative effect and safety of preoperative tirofiban combined with intraoperative small dose intracoronary administration in emergency percutaneous coronary intervention (PCI) surgery. Methods A total of 102 patients with acute ST-segment elevation myocardial infarction (STEMI) were randomly divided into research group (52 cases) and control group (50 cases). Tirofiban was given to the research group before operation, while not to the control group. Comparisons were made on spontaneous recanalization rate of infarction related artery (IRA), incidences of slow flow and no-reflow in PCI, and incidences of major adverse cardiovascular events (MACE) and bleeding events in 7 d after PCI between the two groups. Results The research group had higher spontaneous recanalization rate of IRA showed by coronary angiogram than the control group, and its incidences of slow flow and no-reflow were lower than the control group. The differences between the two groups had statistical significance (P<0.05). The research group had lower incidence of MACE events in 7 d after surgery than the control group, but their difference had no statistical significance (P>0.05). Both groups had no severe bleeding events. Conclusion Preoperative tirofiban combined with intraoperative small dose intracoronary administration in emergency PCI surgery provides better effect in improvement of IRA flow than intraoperative intracoronary administration, without risk of bleeding as well.