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目的评价血栓抽吸疗法联合国产替罗非班,在急性ST段抬高型心肌梗死(STEMI)急诊冠脉介入治疗(PCI)中的临床疗效及安全性。方法选择2008年6月至2009年6月因STEMI在中国医科大学附属第四医院行PCI患者102例。其中50例(A组)术前常规应用替罗非班,血栓抽吸治疗后行PCI术;另外52例(B组)术前常规应用替罗非班后完成PCI术。结果冠状动脉造影显示两组心肌灌注分级(TMP)0～1级(P=0.466)、TMP2级(P=0.142)比率差异无统计学意义;TMP3级(P=0.031)、心电图总ST段回落≥50%(P=0.026)比率A组优于B组;A组手术时间(P=0.001)、X线曝露时间(P=0.001)高于B组。术后随访半年,两组患者均无心血管事件发生。结论血栓负荷较重的STEMI患者急诊PCI中联合应用替罗非班和吸栓导管方法安全有效。
Objective To evaluate the clinical efficacy and safety of thrombolysis combined with tirofiban in acute coronary intervention (STEMI) in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods From June 2008 to June 2009, 102 patients with PCI underwent STEMI at the Fourth Affiliated Hospital of China Medical University. Among them, 50 patients (group A) were treated with tirofiban preoperatively and thrombectomy therapy followed by PCI. Another 52 patients (group B) received routine tirofiban preoperative PCI. Results Coronary angiography showed that there was no significant difference in TMP level 0 ~ 1 (P = 0.466) and TMP2 level (P = 0.142) between the two groups. TMP3 level (P = 0.031) The rate of ≥50% (P = 0.026) in group A was better than that in group B. The operation time of group A (P = 0.001) and the time of X - ray exposure (P = 0.001) were higher than those in group B. After six months of follow-up, no cardiovascular events occurred in both groups. Conclusion STEMI patients with severe thrombus load are safe and effective in combination with tirofiban and catheterization in emergency PCI.