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1、替罗非班在急性心肌梗死介入治疗中的临床研究[摘耍]冃的:观察在急性心肌梗死(AMI)患者经皮行冠状动脉介入治疗(PCI)时替罗非班的有效性及安全性。方法:60例已确诊的AMI患者PCI术前随机分为替罗非班组(替罗非班+PCI,30例)和对照组(常规PCI,30例)。替罗非班组PCI术静脉应用替罗非班+半虽:肝素,对照组仅应用全量肝素治疗,观察两组PCI术后即刻梗死相关动脉(IRA)TMP(TIMImyocardialperfusion)血流情况,24h及30d主要不良心脏事件(MACE)发生率,出血事件发生率。结果:替罗非班组
2、TMP3级为96.7%(29/30),对照组为80.0%(24/30)(P<0.05),主要不良心脏事件发生率替罗非班组&7%(2/30),对照组16.7%(5/30)(P<0.05),出血事件发生率无统计学意义(P>0.05)。结论:替罗非班可安全用于急性心肌梗死介入治疗中,改善心肌组织再灌注,减少不良心脏事件,疗效优于常规治疗。[关键词]替罗非班;急性心肌梗死;冠状动脉介入治疗;有效性;安全性[中图分类号]R541[文献标识码]A[文章编号11673-7210(2008)05(b)-011-03Efficacyandsaf
3、etyoftirofibanforpercutancouscoronaryinterventioninpatientswithacutemyocardialinfarctionWANGXiao-ping,QINYing(DepartmentofCardiology,ShenzhouHospitalofShenyangMedicalCollege,Shenyang100002,China)[Abstract]Objective:")evaluatetheefficacyandsafetyoftirofibanforpercuta
4、neouscoronaryinterventioninpatientswithacutemyocardialinfarction.Methods:60patientsdiagnosedAMIwererandomlydividedintotirofibangroup(n=30)whoreceivedtirofibanandhalf-heparindose,andthecontrolgroup(n=30),whoweretreatedbyfulldosehcparinduringPCI.ThecoronaryTMPflowofIR
5、AafterPCI,majoradversecardiacevents(MACE)rateswithin24hoursand30days,bleedingrateswereanalyzedandcomparedbetweenthetwogroups.Results:ThreedegreeTTMTmyocardialperfusionoftirofibangroupwas96.7%(29/30),butthecontrolgroupwas80.0%(24/30)(P<0.05).TheMACErateoftirofibangro
6、upwas6.7%(2/30),butthecontrolgroupwas16.7%(5/30)(P<0.05).Therewerenodifferenceofcomplicationofbleedingbetweenthetwogroups.Conclusion:TheresultssuggestthattirofibanisasafeandmoreefficacioustherapyforthepatientswithAMTduringPCTcomparedwithconventionaltherapy,whichcani
7、mprovethesituationofmyocardialreperfusionanddegreetheMACE・[Keywords]Tirofiban;Acutemyocardia1infarction;Percutaneouscoronaryintervention;Efficacy;Safety急性心肌梗死(AMI)是在冠状动脉粥样硕化、斑块破裂的阜础上形成血栓,使冠状动脉急性闭塞所致的临床综合征。由于血小板在血栓形成过程屮的作用,抑制和拮抗血小板黏附和聚集反应是防I上血栓形成的关键环节。随着药物洗脱支架(DES)时代
8、的到來,经皮冠状动脉介入治疗(PCI)已经成为治疗冠心病最有效、最普遍的方法,成为急性心肌梗死再灌注治疗的垂要手段。但介入术中冠脉内血栓并发症仍不容忽视,尤其是急性心肌梗死患者,虽经肝索、阿司匹林、氯毗格雷等强化抗凝、抗栓治疗,但介入术中血栓发牛率仍高,有效的方法是使用更强效