CAJ | 학술논문

目的：探讨血栓抽吸术联合替罗非班在急性ST段抬高性心肌梗死(ASTEMI)患者急诊介入中的临床效果。方法：2011年1-12月收治 ASTEMI 患者46例作为对照组，采用单纯 PCI 联合替罗非班治疗。2013年1-12月收治ASTEMI患者60例作为治疗组，采用血栓抽吸术、冠脉内替罗非班注射、PCI联合术后静滴替罗非班。观察两组术后TIMI血流分级、术后1.5 h心电图ST段回落程度、肌酸激酶同工酶达峰时间、术后30 d左室射血分数、出院30 d的主要心血管事件以及出血事件等。结果：治疗组ST段回落比率(90%)明显高于对照组(73.9%)(P＜0.05)。治疗组肌酸激酶同工酶均值低于对照组(P＜0.05)。治疗组达峰时间较对照组提前(P＜0.05)。治疗组术后30 d左室射血分数较术前明显提高，PCI术后30 d恶性心律失常、心功能不全发生率少于对照组(P＜0.05)。结论：急性ST 段抬高性心肌梗死急诊PCI术中，应用血栓抽吸及替罗非班治疗可增加心肌的有效灌注，改善患者近期预后，安全有效。
목적：탐토혈전추흡술연합체라비반재급성ST단태고성심기경사(ASTEMI)환자급진개입중적림상효과。방법：2011년1-12월수치 ASTEMI 환자46례작위대조조，채용단순 PCI 연합체라비반치료。2013년1-12월수치ASTEMI환자60례작위치료조，채용혈전추흡술、관맥내체라비반주사、PCI연합술후정적체라비반。관찰량조술후TIMI혈류분급、술후1.5 h심전도ST단회락정도、기산격매동공매체봉시간、술후30 d좌실사혈분수、출원30 d적주요심혈관사건이급출혈사건등。결과：치료조ST단회락비솔(90%)명현고우대조조(73.9%)(P＜0.05)。치료조기산격매동공매균치저우대조조(P＜0.05)。치료조체봉시간교대조조제전(P＜0.05)。치료조술후30 d좌실사혈분수교술전명현제고，PCI술후30 d악성심률실상、심공능불전발생솔소우대조조(P＜0.05)。결론：급성ST 단태고성심기경사급진PCI술중，응용혈전추흡급체라비반치료가증가심기적유효관주，개선환자근기예후，안전유효。
Objective:To explore the clinical effects of thrombus aspiration combined with tirofiban in the treatment of acute ST-segment elevation myocardial infarction(ASTEMI).Methods:46 cases of ASTEMI as the control group from January to December in 2011 were treated with simple PCI combined with tirofiban.60 cases of ASTEMI as the treatment group from January to December in 2011 were treated with thrombus aspiration,intravascular tirofiban for injection and PCI combined with intravascular tirofiban postoperative.The indicators including postoperative TIMI flow grade,ST-segment resolution 1.5 h after surgery,the time to peak of creatine kinase isoenzyme,left ventricle ejection fraction 30 d after surgery,major cardiovascular events and bleeding events post-discharge of the two groups were observed.Results:The ST-segment resolution rate of the treatment group(90%) was significantly higher than that of the control group(73.9%)(P<0.05).The average creatine kinase isoenzyme of the treatment group was lower than that of the control group(P<0.05).The time to peak of creatine kinase isoenzyme of the treatment group was shorter than that of the control group(P<0.05).The left ventricle ejection fraction 30 d after surgery of the treatment group improved more obviously than that of the control group.The incidence of malignant arrhythmia and cardiac insufficiency of the treatment group was lower than that of the control group(P<0.05).Conclusion:Transcatheter thrombus aspiration combined with tirofiban in the treatment of acute ST-segment elevation myocardial infarction can increase the myocardial perfusion effectively and improve the short-term prognosis,which is safeand effective.