盐酸替罗非班在急性心肌梗死患者急诊冠状动脉介入治疗围术期的应用The efficacy and safety of tirofiban during perioperation of emergency percutanous coronary intervention in acute myocardial infarction
曹绪芬,卢清龙,韩立宪,袁琛,王钢,赵荣诚,王娟,程晓明
摘要(Abstract)：
目的观察血小板糖蛋白(glycoprotein,GP)Ⅱb/Ⅲa受体拮抗剂盐酸替罗非班在急性心肌梗死(AMI)患者急诊冠状动脉(冠脉)介入治疗(PCI)围术期的疗效及安全性。方法AMI患者经急诊冠脉造影示TIMI 0~1级,预计行PCI者90例按就诊顺序分为替罗非班组(n=45)和对照组(n=45)。替罗非班组PCI术前开始应用盐酸替罗非班,持续泵入至术后36~48 h。对照组同常规PCI。观察两组冠脉复流3、0 d再梗死及死亡情况,并监测术前、术后血小板活化度。结果替罗非班组急诊PCI术后无慢复流、无复流现象发生,TIMI 3级血流发生率100%;对照组急诊PCI术后TIMI 0~2级,即无复流及慢复流发生率11.10%(5/45),TIMI 3级血流发生率88.90%(40/45),两组比较差异有统计学意义。观察30 d盐酸替罗非班组无再梗死及死亡;对照组再梗死及死亡发生率6.66%(3/45),两组比较差异有统计学意义。盐酸替罗非班可明显降低血小板活化度,不增加出血并发症。结论在AMI急诊PCI围术期应用盐酸替罗非班既可开通冠脉,又可改善冠脉血流,减少术后再梗死,达到真正意义上挽救心肌的目的。
关键词(KeyWords)： 心肌梗死;血管成形术,经腔,经皮冠状动脉;手术期间
基金项目(Foundation):
作者(Author): 曹绪芬,卢清龙,韩立宪,袁琛,王钢,赵荣诚,王娟,程晓明
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