替罗非班对急性心肌梗死急诊冠状动脉介入治疗无复流的影响

目的探讨替罗非班对急性心肌梗死（AMI）急诊经皮冠状动脉介入治疗（PCI）中并发的无复流现象的影响。方法对我院2007年6月至2008年10月进行急诊PCI治疗成功的102例AMI患者随机分为两组，对照组50例和替罗非班治疗组52例。两组均在急诊PCI术前30min嚼服阿司匹林300mg及氯吡格雷600mg，术中普通肝素用量为70IU／kg，治疗组在急诊PCI术前即刻静脉推注替罗非班（欣维宁，武汉远大制药集团有限公司）10μg／kg，继以静脉滴注0．15μg/（kg·min），持续24—36h。结果对照组发生无复流6例（12．0％），其中发生心血管崩溃死亡1例。替罗非班治疗组发生无复流1例（1．9％），无死亡病例，两组疗效对比差异有统计学意义（P〈0．01）。结论替罗非班能有效防治AMI急诊PCI治疗术中无复流的发生。

Effects of tirofiban on no - reflow during emergency percutaneous coronary intervention for acute myocardial infarction

Objective To evaluate the effects of tirofiban on no - reflow during emergency percutaneous coronary intervention（PCI） for acute myocardial infarction （AMI）. Methods One hundred and two patients with AMI of persuing PCI were randomly divided into two groups, control group （ n = 50） and tirofiban treated group （ n = 52 ）. Two groups used aspilin 300 mg and clopidogrel 600 mg before PCI, Tirofiban was predominantly initiated in the catheter before or during the intervention and maintained for a mean of 30 h [ 10 μg/kg for bolus followed by 0.15 μg/（ kg ·min） infusion ]. Results Control group developed no - reflow 6 cases （ 12% ） , complicated cardiovascular collapse dead 1 case, tirofiban - treated group developed no- fellow 1 case（ 1.9% ）. There was significant difference between the two groups （ P 〈 0.01 ）. Conclusions Conclusions tirofiban is effective in preventing and treating no - reflow during PCI for AMI.