CAJ | 학술논문

目的：探讨急性ST段抬高心肌梗死（ASTEMI）行急诊直接冠状动脉成形术（PCI）患者术前使用替罗非班及其时间对梗死相关血管（IRA）血流的影响。方法：2009年1月到2012年10月266例 ASTEMI行直接PCI的患者被随机分为替罗非班组（134例， PCI前开始静脉使用替罗非班），常规治疗组（132例， PCI前未使用替罗非班），按急诊使用替罗非班时间（3h）分＜3h组和≥3h两亚组，比较各组PCI前后 IRA的 TIMI血流。结果：PCI术前，与常规治疗组比较，替罗非班组TIMI3级血流者比例（10.6％比20.9％， P＝0.028）明显提高；PCI术后，替罗非班组TIMI3级血流者比例升高更显著（78.8％比92.5％， P＝0.001）；术前替罗非班组＜3h组（63例）较≥3h组（71例）血流明显改善（TIMI2级＋3级，63.5％比29.6％， P＜0.01）。结论：早期使用替罗非班可改善急性ST抬高型心肌梗死患者梗死相关血管的PCI术后TIMI血流，且越早使用作用越明显。
목적：탐토급성ST단태고심기경사（ASTEMI）행급진직접관상동맥성형술（PCI）환자술전사용체라비반급기시간대경사상관혈관（IRA）혈류적영향。방법：2009년1월도2012년10월266례 ASTEMI행직접PCI적환자피수궤분위체라비반조（134례， PCI전개시정맥사용체라비반），상규치료조（132례， PCI전미사용체라비반），안급진사용체라비반시간（3h）분＜3h조화≥3h량아조，비교각조PCI전후 IRA적 TIMI혈류。결과：PCI술전，여상규치료조비교，체라비반조TIMI3급혈류자비례（10.6％비20.9％， P＝0.028）명현제고；PCI술후，체라비반조TIMI3급혈류자비례승고경현저（78.8％비92.5％， P＝0.001）；술전체라비반조＜3h조（63례）교≥3h조（71례）혈류명현개선（TIMI2급＋3급，63.5％비29.6％， P＜0.01）。결론：조기사용체라비반가개선급성ST태고형심기경사환자경사상관혈관적PCI술후TIMI혈류，차월조사용작용월명현。
Objective:To explore influence of preoperative tirofiban usage and using time on blood flow of infarct re-lated artery (IRA) in patients with acute ST elevation myocardial infarction (ASTEMI ) undergoing emergency di-rect percutaneous coronary intervention (PCI ) .Methods:A total of 266 ASTEMI patients undergoing direct PCI from Jan 2009 to Oct 2012 ,were randomly divided into tirofiban group (n=134 ,received preoperative tirofiban us-age for PCI) and routine treatment group (n=132 ,didn't receive tirofiban during PCI) .According to percutaneous using time of tirofiban tirofiban group was divided into <3h group (n= 63) and ≥3h group (n= 71) ;TIMI blood flow of IRA ,before and after PCI were compared among different groups .Results:Compared with routine treat-ment group before PCI ,there were significant rise in percentages of TIMI grade 3 (10.6% vs .20.9% ) in tirofiban group ,P=0.028 ;after PCI ,percentage of TIMI grade 3 in tirofiban group was more significantly rose than that of routine treatment group (78.8% vs .92.5% ,P=0.001);in tirofiban group ,blood flow of IRA before PCI in <3h group was significantly improved compared with ≥3h group (TIMI grade 2 + 3 ,63.5% vs .29.6% , P<0.01) . Conclusion:Early tirofiban usage can improve TIMI blood flow of IRA before and after PCI in ASTEMI patients , the earlier it′s used ,the more significant effect it has .