血栓抽吸导管联合替罗非班在急诊冠状动脉介入治疗中的应用

目的 探讨血栓抽吸导管联合替罗非班在急诊冠状动脉介入治疗中的有效性及安全性.方法 将88例急性心肌梗死患者随机分为治疗组（46例）和对照组（42例）,治疗组采用血栓抽吸导管联合替罗非班治疗,对照组行标准经皮冠状动脉介入（PCI）治疗.所有患者术后行冠状动脉造影,观察术后冠状动脉TIMI血流分级、无复流或慢血流发生率;1周后超声心动图检查,记录左心室射血分数（LVEF）和左室舒张末期内径（LVEDD）,住院期间再梗死、再次血运重建、心力衰竭、死亡等主要心脏不良事件发生率,大出血的发生率.结果 术后治疗组TIMI 3级血流比例高于对照组,无复流发生率明显低于对照组（P＜0.05）,LVEF明显高于对照组（P＜0.05）,两组LVEDD差异无统计学意义（P＞0.05）;住院期间对照组心力衰竭、病死率均高于治疗组（P＜0.05）.结论 血栓抽吸导管联合替罗非班是处理冠状动脉内血栓安全、有效的方法,可改善心肌灌注及近期预后.

The application of thrombus aspiration catheter combined with tirofiban in treatment of percutaneous coronary intervention

Objective To investigate the effectiveness and safety of thrombus aspiration catheter combined with tirofiban in treatment of pereutaneous coronary intervention （PCI）.Methods 88 cases of patients with acute myocardial infarction were randomly divided into treatment group （46 cases） and control group （42 cases）.Thrombus aspiration catheter combined with tirofiban was used to treatment group,while the control group were received standard PCI oper- ation.All patients were underwent coronary angiography,coronary TIMI flow grade,the incidence of no-reflow or slow flow after operation was observed; left ventricular ejection fraction record （LVEF） and left ventrieular end-diastolic di- ameter （LVEDD）,reinfarction during hospitalization,revascularization,heart failure,and death rate of major adverse car- diac events,the incidence of major bleeding was recorded after 1 week according to the eehocardiography.Resuits After operation,the TIMI 3 level of blood flow ratio in the treatment group was better than that in the eontrol group,no-reflow rate was significantly lower than that of the control group （P〈0.0J）;The LVEF in the treatment group was significantly higher than that in the control group （P〈0.OS）,and there was no significant difference in LVEDD between two groups （P〉0.0J）.The heart failure and mortality rate in the control group was higher than those in the treatment group during the period of hospitalization （P〈0.05）.Conclusion The method of thrombus aspiration catheter combined with tirofiban in treatment of PCI is safe and effective,it can improve myocardial perfusion and recent prognosis.