盐酸替罗非班对急性心肌梗死急诊经皮冠状动脉介入治疗中TIMI血流影响的临床研究

目的分析Ⅱb/Ⅲa受体拮抗剂盐酸替罗非班对ST段抬高急性心肌梗死(STEMI)患者急诊经皮冠状动脉介入治疗(PCI)治疗中TIMI血流的影响。方法选择急诊入院STEMI患者48名,分为试验组(盐酸替罗非班+PCI)27例和对照组(直接PCI)21例。收集所有病例的临床和冠状动脉造影资料,观察PCI术前、术后TIMI血流情况。结果试验组于术前应用盐酸替罗非班使PCI前梗死相关血管TIMI血流分级提高,试验组达1级血流者比例高于对照组(37%比9.5%,P<0.05);对照组完全闭塞者比例明显高于试验组(38.1%比7.4%,P<0.01);两组患者PCI术后TIMI3级血流比例差异无统计学意义,TIMI2级血流比例试验组低于对照组。结论Ⅱb/Ⅲa受体拮抗剂盐酸替罗非班可改善STEMI患者梗死相关血管的TIMI血流。

Effect of tirofiban on TIMI flow in patients with STEMI during primary PCI

Objective To eveluate the effect of tirofiban on TIMI flow in patients with STEMI during primary PCI. Methods Forty-eight patients with STEMI who underwent primary PCI were randomly divided into two groups which were: the tirofiban+PCI group (n=27) and the primary PCI group (n=21). The TIMI flow before and after the operation were reviewed angiographically. Results A greater percentage of TIMI 1 flow was archieved in the triofiban+PCI group compared with the primary PCI group before operation (37% vs 9.5%, P<0.05). On the other hand, TIMI 0 flow was more commonly found in patients in the primary PCI group compared with the tirofiban+PCI group (38.1% vs 7.4%, P<0.01). There was no difference in the archievement of TIMI 3 flow between the two groups after operation, but the occurance of TIMI 2 flow was less in the tirofiban+PCI group compared with the primary PCI group. Conclusion Tirofiban may improve TIMI flow of the IRA in patients with STEMI during primary PCI.