血栓抽吸盐酸替罗非班在急性心肌梗死急诊介入治疗中的临床应用

目的：观察血栓抽吸、盐酸替罗非班在急性心肌梗死急诊介入治疗患者中的应用,并探讨其安全性、有效性。方法宣城市中心医院2011年6月至2013年6月收治急性心肌梗死行急诊介入治疗的患者60例,其中血栓抽吸、冠脉内注射替罗非班组(A组)32例,标准经皮冠状动脉介入治疗(PCI)组(B组)28例。 A组术中行血栓抽吸,GPⅡb/Ⅲa受体拮抗剂盐酸替罗非班持续给予36 h,同时肝素抗凝,监测APTT；B组行标准PCI术。结果 A组在联合阿司匹林、氯吡格雷及肝素抗栓基础上加用血栓抽吸、冠脉内给予替罗非班明显地改善PCI术后梗死相关血管的血流、胸痛症状、心电图好转、心肌的损伤及左室重构,术后2周左心室射血分数明显高于B组；同时,减少了30 d内主要心血管不良事件发生率,而出血病例并没有增加。结论急性心肌梗死行急诊介入治疗患者应用血栓抽吸、替罗非班效果良好,且安全有效。

Clinical application of thrombus aspiration and tirofiban hydrochloride in emergency interventional therapy of acute myocardi-al infarction

Objective To investigate the effects and security of thrombus aspiration and tirofiban hydrochloride in emergency inter-ventional therapy of acute myocardial infarction. Methods Sixty acute myocardial infarction cases with PCI interventional therapy were di-vided randomly into two groups, 32 in thrombus suction and tirofiban hydrochloride group and 28 in PCI group. The TIMI blood flow, chest pain relief, the peak of decreased CK and CK-MB, LVEF, left ventricular end-diastolic diameter and adverse cardiovascular event of the two groups were observed. Results The difference of TIMI blood flow, STR>50%, chest pain relief, the peak of decreased CK and CK-MB, LVEF, adverse cardiovascular event between the two groups had statistical significance(P<0. 05). There was no thrombocytopenia, and the bleeding complications between two groups had no statistical significance(P<0. 05). Conclusion There are significant effects and high se-curity of thrombus aspiration and tirofiban hydrochloride in emergency interventional therapy of acute myocardial infarction.