血栓抽吸联合冠状动脉内替罗非班对急性ST段抬高型心肌梗死患者的疗效分析

目的:研究血栓抽吸联合冠状动脉内替罗非班对接受急诊PCI术的急性ST段抬高型心肌梗死(STEMI)患者预后的影响.方法:回顾性分析89例接受急诊PCI术的急性STEMI患者的临床资料,分析比较支架植入前行血栓抽吸后冠状动脉内注入替罗非班(A组,53例)与常规PCI后静脉应用替罗非班(B组,36例)两组的冠状动脉造影、UCG及心电图结果.结果:两组PCI术后冠状动脉造影显示的TIMI 3级血流、UCG所示的左心室舒张末期直径(LVEDd)、LVEF、术前及术后1h心电图所示的总ST段回落≥50％比率、梗死相关血管(IRA)无复流发生率比较差异均有统计学意义.两组的住院期间主要不良心血管事件(MACE)发生率比较无统计学意义.结论:对于急性STEMI明显血栓负荷的患者,血栓抽吸联合冠状动脉内替罗非班后PCI术的治疗方案安全有效.

Analysis of the effect on thrombus aspiration in combination with intracoronary tirofiban injection in patients with acute myocardial infarction

Objective： To research the prognosis of thrombus aspiration in combination with intracoronary （IC） tirofiban injection in patients undergoing primary percutaneous coronary intervention （PCI） with acute ST- segment elevation myocardial infarction （STEMI）. Methods： Eighty-nine acute STEMI patients undergoing primary PCI were retrospectively analyzed. Patients undergoing thrombus aspiration followed by intracoronary tirofiban injection before stent implantation were defined as group A （n = 53 ）, and patients undergoing tirofiban injection intravenously after stent implantation were defined as group B （ n = 36）. The data of angiography, UCG and ECG of both groups were compared. Results： The ratio of final TIMI grade three flow, LVEDd, LVEF, and 50% resolution ratio of sum of ST- segment elevation were higher in group A than in group B, and the no-reflow incidence of IRA was lower in group A （P 〈 0. 05 ）. But there was no significant difference of hospital MACE incidence between the two groups. Conclusion： Thrombus aspiration combined with IC tirofiban is effective and safe for STEMI pa- tients undergoing primary PCI with prominent thrombus burden.