急诊冠状动脉介入治疗术中应用替罗非班改善冠脉血流临床疗效研究

目的了解ST段抬高型急性心肌梗塞急诊冠状动脉介入治疗术中应用替罗非班是否改善冠脉血流和心肌灌注。方法将2007年1月至2010年5月因ST段抬高型急性心肌梗塞住院的72例患者随机分为两组A组（急诊介入术中应用替罗非班）与B组（急诊介入术中不应用替罗非班）。观察两组在常规使用阿斯匹林,氯吡格雷基础上介入治疗术后靶血管血流分级与心肌灌注分级及出血并发症的发生率。结果 A组急诊介入术后即刻靶血管TIMI血流2～3级（97.2%）心肌灌注（TMPG）2-3级（97.2%）均显著高于B组（91.6%,88.8%）。两组出血并发症比较差异无统计学意义。结论 ST段抬高型急性心肌梗塞急诊冠状动脉介入治疗术中应用替罗非班能有效改善冠脉血流和心肌灌注,并不增加出血风险。

Clinical research of tirofiban on patency and myocardial perfusion in ST segment elevation acute myocardial infarction undergoing percutaneous coronary interventions

Objective to evaluate how can tirofiban on patency and myocardial perfusion in ST segment elevation acute myocardial infarction undergoing percutaneous coronary intervention（PCI）.Methods from January 2007 to may 2010,72 cases with ST segment elevation acute myocardial infarction undergoing percutaneous coronary intervention（PCI） were randomized to receive tirofiban and without tirofiban.Based on pretreatment with aspirin and clopidogrel,to observe the TIMI flow grade and the TIMI myocardial perfusion grade（TMPG） of target artery after PCI,to observe the incidence of bleeding complications.Results the TIMI flow grade2-3 and TMPG2-3 perfusion were significantly more frequent with tirofiban compared no tirofiban after PCI.Conclusion tirofiban can significantly improve TIMI flow grade and the TIMI myocardial perfusion grade（TMPG） of target artery after PCI,but can not add bleeding complication.