心血管康复医学杂志
心血管康複醫學雜誌
심혈관강복의학잡지
JOURNAL OF CARDIOVASCULAR REHABILITATION MEDICINE
2015年
4期
398-402
,共5页
李佳璐%苏哲%王旖旎%周长勇
李佳璐%囌哲%王旖旎%週長勇
리가로%소철%왕의니%주장용
心肌梗死%血管成形术,气囊,冠状动脉%替罗非班
心肌梗死%血管成形術,氣囊,冠狀動脈%替囉非班
심기경사%혈관성형술,기낭,관상동맥%체라비반
Myocardial infarction%Angioplasty,balloon,coronary%Tirofiban
目的：评价 ST 段抬高型心肌梗死（STEMI）患者急诊经皮冠状动脉介入治疗（PCI）中在梗死相关血管注射替罗非班的有效性和安全性。方法：我科2013年1月至2014年6月收治的30例 STEMI 患者作为替罗非班组，急诊 PCI 术中梗死相关血管内应用替罗非班500μg，植入支架后静脉滴注24h 替罗非班0.1μg·kg－1·min－1；同期的31例 STEMI 患者作为单纯支架组，急诊 PCI 术后直接植入支架。比较并分析两组支架植入后计算机辅助定量心肌灌注评分（QuBE 分值），住院期间及6个月随访左心室射血分数（LVEF）、主要不良心血管事件（MACE）发生率。结果：两组患者基线资料差异无统计学意义（P ＞0.05）。6个月后，与单纯支架组比较，替罗非班组QuBE 分值[（10.88±5.03）分比（14.70±6.69）分]及 LVEF [（57.19±4.59）％比（59.80±5.34）％]显著升高，而 MACE 发生率（35.5％比10.0％）显著降低（P 均＜0.05）。结论：ST 段抬高型心肌梗死患者急诊经皮冠状动脉介入治疗中在梗死相关血管应用替罗非班可以有效，安全地改善心肌微循环灌注水平，值得推广。
目的：評價 ST 段抬高型心肌梗死（STEMI）患者急診經皮冠狀動脈介入治療（PCI）中在梗死相關血管註射替囉非班的有效性和安全性。方法：我科2013年1月至2014年6月收治的30例 STEMI 患者作為替囉非班組，急診 PCI 術中梗死相關血管內應用替囉非班500μg，植入支架後靜脈滴註24h 替囉非班0.1μg·kg－1·min－1；同期的31例 STEMI 患者作為單純支架組，急診 PCI 術後直接植入支架。比較併分析兩組支架植入後計算機輔助定量心肌灌註評分（QuBE 分值），住院期間及6箇月隨訪左心室射血分數（LVEF）、主要不良心血管事件（MACE）髮生率。結果：兩組患者基線資料差異無統計學意義（P ＞0.05）。6箇月後，與單純支架組比較，替囉非班組QuBE 分值[（10.88±5.03）分比（14.70±6.69）分]及 LVEF [（57.19±4.59）％比（59.80±5.34）％]顯著升高，而 MACE 髮生率（35.5％比10.0％）顯著降低（P 均＜0.05）。結論：ST 段抬高型心肌梗死患者急診經皮冠狀動脈介入治療中在梗死相關血管應用替囉非班可以有效，安全地改善心肌微循環灌註水平，值得推廣。
목적：평개 ST 단태고형심기경사（STEMI）환자급진경피관상동맥개입치료（PCI）중재경사상관혈관주사체라비반적유효성화안전성。방법：아과2013년1월지2014년6월수치적30례 STEMI 환자작위체라비반조，급진 PCI 술중경사상관혈관내응용체라비반500μg，식입지가후정맥적주24h 체라비반0.1μg·kg－1·min－1；동기적31례 STEMI 환자작위단순지가조，급진 PCI 술후직접식입지가。비교병분석량조지가식입후계산궤보조정량심기관주평분（QuBE 분치），주원기간급6개월수방좌심실사혈분수（LVEF）、주요불양심혈관사건（MACE）발생솔。결과：량조환자기선자료차이무통계학의의（P ＞0.05）。6개월후，여단순지가조비교，체라비반조QuBE 분치[（10.88±5.03）분비（14.70±6.69）분]급 LVEF [（57.19±4.59）％비（59.80±5.34）％]현저승고，이 MACE 발생솔（35.5％비10.0％）현저강저（P 균＜0.05）。결론：ST 단태고형심기경사환자급진경피관상동맥개입치료중재경사상관혈관응용체라비반가이유효，안전지개선심기미순배관주수평，치득추엄。
Objective:To evaluate the efficacy and safety of tirofiban infusion to infarct related vessels on patients with ST segment elevation myocardial infarction (STEMI)during emergency percutaneous coronary intervention (PCI).Methods:From Jan 2013 to Jun 2014,a total of 30 STEMI patients were enrolled as tirofiban group (tirofi-ban 500μg was infused to infarct related vessels during emergency PCI),and received intravenous drip of tirofiban 0.1 μg·kg-1 ·min-1 for 24h after stent implantation;another 31 STEMI patients were regarded as pure stenting group during the same period and they received direct stent implantation during emergency PCI.Computer-assisted Quantitative Blush Evaluator (QuBE)score,left ventricular ejection fraction (LVEF)during hospitalization and af-ter six-month follow-up and incidence rate of major adverse cardiovascular events were compared and analyzed be-tween two groups.Results:There were no significant difference in baseline data between two groups,P > 0.05. Compared with pure stenting group,after six months,there were significant rise in QuBE score [(10.88±5.03) scores vs.(14.70±6.69)scores]and LVEF [(57.19±4.59)% vs.(59.80±5.34)%],and significant reduction in incidence rate of MACE (35.5% vs.10.0%)in tirofiban group,P <0.05 all.Conclusion:Tirofiban application in infarct related vessels during emergency PCI in STEMI patients can effectively and safely improve myocardial micro-circulation perfusion level and it is worth extending.
