血小板Ⅱb/Ⅲa受体拮抗剂联合药物洗脱支架治疗急性心肌梗死临床观察

目的探讨血小板Ⅱb／Ⅲa受体拮抗剂——替罗非班（欣维宁）联合药物洗脱支架治疗急性心肌梗死（AMI）的安全性和有效性。方法因AMI行经皮腔内冠状动脉介入（PCI）治疗的患者52例，于置入药物洗脱支架前予国产替罗非班（欣维宁）负荷量后，以维持量持续静脉泵入48h，观察手术成功率、围手术期出血血栓并发症及1～3个月的主要心脏不良事件（包括死亡，靶血管再次重建术）和出血发生。结果52例患者PCI均取得成功，手术成功率100％，无严重出血并发症，无急性、亚急性血栓及慢血流发生。治疗无死亡，无再发心梗及靶血管再次血运重建，围手术期血小板聚集率明显降低。结论欣维宁联合药物洗脱支架行急诊PCI治疗急性心肌梗死安全有效，不增加出血危险性，可明显降低围手术期及近期并发症。

Observation of the effect of homemade tirofiban combined with the drug eluting stent on the treatment of acute myocardial infarction

Objective To evaluate the safety and efficiency of homemade tirofiban combined with drug-eluting stent in the treatment of acute myocardial infarction. Methods Fifty-two cases of myocardial infarction patients were used the load dose homemade tirofiban(Xinweining) before the percutanenous coronary interventions (PCI), then pumped for 48 hours with the sustaining dose. The success rate of operations, peri-operational bleeding and thrombosis complications and main adverse cardiac events were observed, the platelet aggregation rate was monitored. Results Fifty-two patients were all performed PCI successfully,the success rate of operation was 100%,there were no serious bleeding complications. acute or subacute intra-stent thrombosis and slow reflow phenomenon occurred. There were no re-infarction and target vascular reperfusion occurred. The platelet aggregation rate were obviously decreased during peri-operation.Conclusion Homemade tirofiban combined with drug-ekiting stent,which is safety and efficiency in the treatment of acute myocardial infarction, can obviously decrease the complications of peri-operation and short term.