替罗非班在急性心肌梗死介入治疗中应用

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1、替罗非班在急性心肌梗死介入治疗中应用作者：李卫东张国辉鲍中华真亚郭俊芳张建陈蓉王建平尹春阳王成华陶艾彬【摘要】目的：观察替罗非班在急性心肌梗死(AMI)经皮行冠状动脉介入治疗(PCI)中的临床价值。方法：68例急性心肌梗死行PCI患者随机分为替罗非班组(PCI+替罗非班，28例)和对照组(PCI,40例)，均于发病12h内行急诊PCI术。PCI术前服用氯毗格雷300~600mg阿司匹林300mg,术后各75mg-d-1,PCI术中均给予肝素8000-10000U。替罗非班组PCI术中冠脉内注入盐酸替罗

2、非班10pg-kg-1,静脉维持量0.15pg-kg-1-min-124-36ho观察两组PCI术后即刻梗死相关血管(IRA)心肌梗死溶栓(TIMI分级)血流情况,术后30天内出血并发症及主要不良心脏事件(MACE)的发生情况。结果：替罗非班组TIMI3级血流96.4%(27/28),对照组82.5%(33/40)(P&t;0・05);主要不良心脏事件的发生率替罗非班组7.1%(2/28)，对照组17.5%(7/40)(P&t;0・05);出血并发症发生率两组比较无统计学意义(P>0.05)o结

3、论：在急性心肌梗死介入治疗中，应用盐酸替罗非班能改善急性心肌梗死患者PCI术后梗死相关血管的TIMI血流，减少PCI术后主要不良心脏事件的发生率，临床应用安全有效。【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[Abstract]Objective:ToevaluatetheclinicalvalueofTirofibanforpercutaneouscoronaryintervention(PCI)inpatientswithacutemyocardialinfarction(A

4、MI).Methods:Atotalof68AMIpatientswererandomlydividedintoTirofibangroup(n二28),andcontrolgroup(n=40).AlltheindividualswereperformedPCIwithin12hoursafteronsetofAMLAlltheindividualsweregivenoralbolusdoseofClopidogrel300~600mg,Aspirin300mgbeforePCIandClopido

5、grel75mgperday,Aspirin75mgperdayafterPCI.Alltheindividualswereintravenousadministeredheparin8000~10000UduringPCI.AlltheTirofibangroupwereinjectedTirofiban(10pg-kg-1)intoartery(IRA)duringPCIandintravenouslyadministeredTirofiban24~36hours(0.15pg-kg-1-min-

6、1)afterPCI.ThecoronaryTIMIflowofIRAafterPCI,majoradversecardiacevents(MACE)rateswithin30days,bleedingcomplicationswereanalyzedandbetweenthetwogroups・Results:ThreedegreeTIMImyocardialperfusionofTirofibangroupwas96.4%(2刀28),butcontrolgroupwas82.5%(33/40)(

7、P<0.05)・TheMACErateofTirofibangroupwas7.1%(2/28),butcontrolgroupwas17.5%(7/40)(P<0.05).Therewerenodifferenceofcomplicationofbleedingbetweenthetwogroups(P>0.05).Conelusion:ApplicationofTirofibanintracoronaryinjectionduringprimaryPCIinpatientswit

8、hAMIwassafeandeffective,whichmayreducetheoccurrenceofMACE,andimproveTIMIflowofIRAinpatientswithAMIduringprimaryPCI.[Keywords]Tirofiban;acutemyocardialinfarction;percutaneouscoronaryintervention;efficacy;safety急诊经皮腔内冠状动脉介入治疗(PCI)是