AMI直接PTCA术应用血小板Ⅱb/Ⅲa受体拮抗剂的安全性及合理性Safety and feasibility of using plateletⅡb/Ⅲa during direct percutaneous transluminal coronary angioplasty in patients with acute myocardial infarction
陶军,靳亚非,刘磊,马虹,杜志民,董吁钢,Vieeca M
摘要(Abstract)：
目的 探讨急性心肌梗塞 (acutemyocardialinfarction ,AMI)直接PTCA术应用血小板Ⅱb/Ⅲa受体拮抗剂abciximab的安全性及合理性和 30天临床随访结果。方法 30例胸痛小于 2hAMI施行直接PTCA术治疗的患者 ,静脉注射小剂量肝素 70U/kg和abciximab 0 2 5mg/kg ,随后abciximab以10 μg/min持续静脉滴注 12h ,观察 30天时死亡率、心肌梗塞、再次急诊冠脉血运重建术和出血发生率。结果 随访 30天 ,未见出血并发症 ,abciximab治疗无一例死亡 ,也未发生心肌梗塞和施行再次冠脉血运重建术。结论 在急性冠脉缺血综合征中 ,应用血小板Ⅱb/Ⅲa受体拮抗剂是安全合理的 ,血小板Ⅱb/Ⅲa受体拮抗剂不增加出血危险性 ,能降低AMI直接PTCA术后患者缺血并发症 ,改善患者预后
关键词(KeyWords)： 急性心肌梗塞;血小板;冠状动脉腔内血管成形术
基金项目(Foundation):
作者(Author): 陶军,靳亚非,刘磊,马虹,杜志民,董吁钢,Vieeca M
参考文献(References)：
- 1ThePARAGONInvestigators.Internationalrandomized,controlledtrialoftamifiban(aplateletglycoproteinⅡb/Ⅲainhibitor),heparin,orbothinunstableangina[J].Circulation,1998,97:23862395.
- 2RaoAK ,PrattC ,BerkeA ,etal.Thrombolysisinmyocardialinfarction(TIMI)trialPhaseI:hemorrhagicmanifestationsandchangesinplasmafibrinogenandfibrinolyticsysteminpatientswithrecombinanttissueplasmingenactivatorandstreptokinase[J].JAmCollCardiol,1998,11:111.
- 3ReverterJC ,BeguinS ,KesselsLL ,etal.Inhibitionofplatelet mediated,tissuefactor inducedthrombingenerationbythemouse/humanchimericTE3antibody:potentialimplicationsfortheeffectofcTE3Fabtrentmentonacutethrombosisandclinilalrestenosis[J].JClinInvest,1996,98:863874.
- 4JonesJI,PrevetteT ,GockermanA ,etal.Ligandoccupacyofthealpha v beta3integrinisnecessaryforsmoothmusclestomigrateinresponsetoinsulin likegrowthfactor[J].ProcNatlAcalSciUSA ,1996,93:24832487.
- 5ShatesMA ,QohetyJM ,GarabedianHQ ,etal.ReoPro,antiplateletantibody,enhancedfibrinolyticpotentialofculturedarterialmicrovascularcells[J].Circulation,1996,94(supplⅠ):Ⅰ702.