血小板糖蛋白Ⅱb∕Ⅲa受体拮抗剂急性ST段抬高型心肌梗死直接PCI术中应用

目的：探讨急性ST段抬高型心肌梗死（STEMI）患者的直接经皮冠状动脉介入治疗（PCI）中,应用血小板糖蛋白Ⅱb∕Ⅲa受体拮抗剂对患者预后的影响。方法：以2010-02～2011-08间入院,诊断为急性STEMI直接PCI患者共36例,术中术后均使用血小板糖蛋白Ⅱb∕Ⅲa受体拮抗剂,作为研究组。以2009-02～2010-01入院,诊断为急性STEMI并接受直接PCI的患者共48例,未使用血小板糖蛋白Ⅱb∕Ⅲa受体拮抗剂,作为对照组。比较两组术后即刻靶血管血流TIME分级情况心电ST段回落情况和严重心脏不良事件（MACE）的发生以及术后1周的射血分数。结果：研究组较对照组血流TIME3级明显增加,ST段完全回落比例增加,术后心功能改善,术后严重心脏不良事件（MACE）的发生减少。结论：急性ST段抬高型心肌梗死患者直接PCI中,应用血小板糖蛋白Ⅱb∕Ⅲa受体拮抗剂能有效降低血栓负荷,增加心肌的有效灌注,而且改善患者预后。

Platelet Glycoprotein B/a Receptor Antagonists in Acute ST Segment Elevation Myocardial Infarction Direct PCI Operation

Objective：To investigate the ST segment elevation acute myocardial infarction（STEMI） patients with direct percutaneous coronary intervention（PCI）,the application of platelet glycoprotein B / a receptor antagonist on patients prognosis.Methods：In 2010 February ~2011 August method between admission,diagnosis of acute STEMI directly PCI36 cases,intraoperative and postoperative use of platelet glycoprotein B/a receptor antagonists,as study group.In 2009 February~2010 January admitted to hospital,diagnosed as acute STEMI and direct PCI 48 cases,without the use of platelet glycoprotein B/a receptor antagonists,as compared to the control group.Comparison of the two groups after the immediate target vessel flow TIME grading ECG ST segment drop condition and serious adverse cardiac events（MACE） occurred and1 week after the ejection fraction.Results：the study group than in the control group,blood TIME3 level increased significantly,ST full fall ratio increases,the postoperative cardiac function improved,postoperative serious adverse cardiac events（MACE） was decreased.Conclusions：acute ST segment elevation myocardial infarction patients directly in PCI,the application of platelet glycoprotein B / a receptor antagonists can effectively reduce thrombus burden,increase myocardial perfusion effectively,and improve the prognosis of patients.