血栓抽吸联合替罗非班对急性下壁心肌梗死的介入治疗作用

目的:观察血栓抽吸导管(ZEEK)抽吸血栓及注入抗栓药物替罗非班对急性下壁心肌梗死介入治疗的效果。方法:需经皮冠状动脉介入治疗(PCI)的急性下壁心肌梗死患者174例,随机分为两组:ZEEK组(n=75),用ZEEK反复抽吸血栓后,经ZEEK注入替罗非班至梗死相关血管(IRA)后行PCI;对照组(n=99),除不进行血栓抽吸外,其余同ZEEK组。比较两组患者的血流改善情况及预后。结果:与对照组比较,ZEEK组术后ST段回落(STR)70%比例(85.33%vs 58.59%)和远端血流分级(TIMI)3级比例(89.33%vs 60.61%)均高于对照组(P0.05);肌酸激酶同工酶(CK-MB)峰值(71.28±10.92V/L vs 98.63±12.71V/L)、峰值时间(11.67±3.23hvs 14.85±3.75h)和校正的TIMI帧数(CTFC)(25.60±6.10vs33.10±6.20)均显著低于对照组(P0.05);两组术后STR50%比例(97.33%vs 93.94%)无明显差异(P0.05),术后3个月两组均未发生主要不良心脏事件(MACE)。结论:在急性下壁心肌梗死患者行PCI前采用ZEEK抽吸血栓和注入替罗非班可改善心肌再灌注和减少心脏损伤。

Effect of ZEEK Thrombus Aspiration Catheter Combined with Tirofiban on Patients with Acute Inferior Wall of Myocardial Infarction

Objective:To explore the clinical effect of ZEEK thrombus aspiration catheter combined with tirofiban on patients with acute inferior wall of myocardial infarction.Method:One hundred and seventy four patients with acute inferior wall of myocardial infarction were enrolled in this study,They were divided into control group(primary PCI alone)and ZEEK group(treated with ZEEK combined with intracoronory tirofiban before stent implantation).Results:The percentage of patients with STsegment resolution(STR)>70% at one hour after operation was significantly higher in ZEEK group than control group.So did the blood flow grade of distal infract relate artery(TIMI)(P<0.05).The peak of CKMB after operation was significantly lower in ZEEK group than control group.So did the apex time of CK-MB and Corrected TIMI frame count(CFTC)(P<0.05).There were no significant difference between two groups in STR>50%and major adverse cardiac events(MACE)(P>0.05).Conclusion:Combination of ZEEK thrombus aspiration catheter and tirofiban can decrease injuries of myocardium and improve myocardial reperfusion.