CAJ | 학술논문

目的：探讨血栓抽吸导管联合冠状动脉内注射替罗非班对急性心肌梗死(AMI)患者经皮冠状动脉介入(PCI)的效果。方法选取本院2010年1月~2014年6月收治的82例AMI患者为研究对象，根据患者意愿分成观察组和对照组。对照组患者在血栓抽吸导管下行PCI手术治疗，观察组患者在此基础上联合冠状动脉内注射替罗非班治疗。记录两组患者心脏超声指标，对比两组手术成功率、ST段回落率、术中大出血率及不良反应发生率等。结果两组患者治疗7 d心脏超声指标对比差异无统计学意义(P>0.05)；观察组患者术后30 d的LVEF、LVEDd、LVESd改善情况明显优于对照组(P<0.05)；两组患者术后均无MACE及术中大出血发生；观察组手术成功率、TIMI血流Ⅲ级率和ST段回落率均高于对照组(P<0.05)；观察组治疗后血压较治疗前差异无统计学意义(P>0.05)；对照组治疗前后血压水平比较差异有统计学意义(P<0.05)。结论血栓抽吸导管联合冠状动脉内注射替罗非班完成PCI手术，TIMI血流良好，安全可靠，值得临床推广。
목적：탐토혈전추흡도관연합관상동맥내주사체라비반대급성심기경사(AMI)환자경피관상동맥개입(PCI)적효과。방법선취본원2010년1월~2014년6월수치적82례AMI환자위연구대상，근거환자의원분성관찰조화대조조。대조조환자재혈전추흡도관하행PCI수술치료，관찰조환자재차기출상연합관상동맥내주사체라비반치료。기록량조환자심장초성지표，대비량조수술성공솔、ST단회락솔、술중대출혈솔급불량반응발생솔등。결과량조환자치료7 d심장초성지표대비차이무통계학의의(P>0.05)；관찰조환자술후30 d적LVEF、LVEDd、LVESd개선정황명현우우대조조(P<0.05)；량조환자술후균무MACE급술중대출혈발생；관찰조수술성공솔、TIMI혈류Ⅲ급솔화ST단회락솔균고우대조조(P<0.05)；관찰조치료후혈압교치료전차이무통계학의의(P>0.05)；대조조치료전후혈압수평비교차이유통계학의의(P<0.05)。결론혈전추흡도관연합관상동맥내주사체라비반완성PCI수술，TIMI혈류량호，안전가고，치득림상추엄。
Objective To explore the curative effects of thrombus aspiration catheter combined with intracoronary in-jection of tirofiban on percutaneous coronary intervention (PCI)for patients with acute myocardial infarction (AMI). Methods 82 patients with AMI in our hospital from January 2010 to June 2014 were selected as research subjects.They were assigned to an observation group and a control group according to patients’ willingness.Patients in the control group were given PCI surgery with thrombus aspiration catheter,patients in the observation group were given the com-bined treatment of intracoronary injection of tirofiban on the basis of the control group.Indices of cardiac ultrasound be-tween two groups of patients were recorded,and surgery successful rate,ST section resolution rate,incidence of hemor-rhage during surgery and incidence of adverse effect were compared and analyzed. Results Indices of cardiac ultra-sound compared between the two groups of patients within 7 days of the treatment was no significant difference (P>0.05).LVEF,LVEDd and LVESd in observation group within 30 days after the surgery was significantly better than that in control group respectively (P<0.05).Two groups of patients with postoperative no MACE and intraoperative bleeding occurred.Surgery successful rate,rate of level Ⅲ TIMI blood flow and ST section reduction rate in observation group was higher than that in control group respectively (P<0.05).Blood pressure in observation group after the treatment was no significant difference compared with before treatment (P>0.05).The blood pressure was statistical difference before and after treatment in control group (P<0.05). Conclusion The treatment of thrombus aspiration catheter combined with intracoronary injection of tirofiban applied in PCI surgery has favorable TIMI blood flow,and is safe and reliable,which is worthy of clinical promotion.