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1、血栓抽吸联合替罗非班在急性心肌梗死急诊介入治疗中的疗效观察石磊白宏索郢安超(内象古乌海市人民医院心内科内象古乌海016000)R的:评价血栓抽吸导管联合替罗非班在急性ST段抬高心肌梗死(STEMI)介入术中应用疗效。方法:选择2012年3月至2014年10月行急诊冠状动脉介入治疗(PCI)的急性ST段抬高心肌梗死患者86例,其屮应用抽吸导管和替罗非班后行PCI组46例,常规PCI对照组40例。观察2组的造影结果、术后效果及安全性。结果:研究组发病距血管再通时间、术后2小时ST段回落>50%和心
2、肌酶学峰值时间均优于对照组(均P<0.05);梗死相关血管(IRA)无复流发生率明显低于对照组(P<0.05),左室射血分数(LVEF)及左室舒张末内径(LVEDd)明显好于对照组,住院期间主要不良心血管事件(MACE,包括死亡、再梗死、再次靶血管重建)的发生率少于对照组,差异有统计学意义(P均<0.05)。结论:血栓抽吸联合替罗非班治疗急性ST段抬高心肌梗死可减少无复流或慢血流发生,可改善术后心脏功能,并且不增加血管不良事件的发生率。【关键词】急性ST段抬高心肌梗死;冠状动脉介入
3、治疗;血栓抽吸导管;替罗非班R453A2095-1752(2015)26-0140-02EffectofthrombusaspirationcombinedwithtirofibanduringurgentpercutaneouscoronaryinterventioninpatientswithacutemyocardialinfarctionShiLei,BaiHong,SuoYing,ANChao.(People’sHospital,Wuhai016000,NeiMonggol,C
4、hina)【Abstract】ObjectiveToevaluatetheeffectofthrombusaspirationcombinedwithTirofibanDuringurgentpercutaneouscoronaryintervention(PCI)inpatientswithacutemyocardialinfarction(AMI).MethodsAtotalof86AMIpatientswithurgentPCIwereenrolledfromMarch2012toOctobe
5、r2014.Therewere46patientsreceivedPCIandsuckbycathetercombinedwithTirofiban,another40patientsreceivedroutinePCI.Observethetwogroupsofangiography,postoperatineefficacy,andsafety.ResultsTherewaslowerpeakserumCK-MB,TNIinthestudygroup,comparedwiththecontrol
6、group,ratioofSTsegmentresolution>50%andthecoronaryarteryrecanalizationtimewassignificantlybetter(P<0.05),no-refiowinInfarct-relatedArtery(IRA)afterPCIwaslowerthanthecontrolgroup(P<0.05),leftventriculardiastolicdiameter(LVEDd),leftventricularej
7、ectionfraction(LVEF)andMACEratesinstadygroupweresuperiortothoseinthecontrolgroup(P<0.05).ConclusionApplicationofsuckbycathetercombinedwithtirofibaninpatientswithacutemyocardialinfarctionwaseffective,whichcoulddecreaseno-reflow/slowflowandimprovecard
8、iacfunctionafterPCI.Anddosenotincreasetheincidenceofbloodvesselevent.【Keywords】AcuteST-segmentelevationmyocardialinfarction;Percutaneouscoronaryintervention;Thrombusaspirationcatheter;Tirofiban急性心肌梗死(AMI)是冠状动脉闭塞,血流中断,使部分心肌因严重的持久性缺血而发生局部