摘要
目的：探讨急性心肌梗死患者冠脉内超选择应用替罗非班与静脉应用替罗非班的临床疗效。方法选择2012年1月～2013年12月期间于我院行介入治疗的患者182例，其中应用冠脉内超声注入替罗非班患者78例，作为观察组；静脉内注入替罗非班患者104例，作为对照组。对注射替罗非班后首次以及PCI手术结束前末次即时冠状动脉造影图像进行分析，评估两组患者心肌梗死溶栓治疗临床试验（TI-MI）与TIMI心肌灌注（TMPG）的血流分级，并计算TIMI贴数计数（cTFC）。结果观察组患者TI-MIⅢ级血流获得率分别为65.38%、82.05%均明显高于对照组患者42.30%、49.04%，差异有统计学意义（x2=5.08、14.08， P均＜0.05）。观察组TMPG Ⅲ级血流获得率分别为60.26%、74.36%均明显高于对照组28.84%、45.19%，差异有统计学意义（x2=7.24、9.31，P均＜0.05）。观察组注射药物后首次及PCI术后末次cTFC分别为（37.75±7.02）帧、（27.03±6.52）帧，均低于对照组患者（51.52±9.53）帧、（42.40±8.52）帧，差异有统计学意义（t=11.50、12.32，P均＜0.05）。结论冠脉内超选择应用替罗非班显著改善冠状动脉血流及心肌组织灌注效，从而降低PCI术后患者无复流现象的发生，值得临床推广。
Objective To investigate the clinical efficacy of tirofiban applied through intracoronary ultrasound and intravenous injection in acute myocardial infarction patients. Methods A total of 182 patients who received interventional therapy in our hospital from January 2012 to December 2013 were selected as the subjects, with 78 cases who received tirofiban by intracoronary ultrasound as the observation group and 104 cases who received tirofiban by intravenous injection as the control group. The images of the first real time coronary angiography after injection of tirofiban and the last real time coronary angiography before the end of PCI surgery were analyzed to evaluate the thrombolysis in myocardial infarction（TIMI） and TIMI myocardial infarction grade as well as calculate the corrected TIMI frame count（cTFC） of two groups. Results The rates of TIMI grade Ⅲ in the observation group were 65.38%and 82.05%, respectively, both higher than 42.30%and 49.04%in the control group, and the difference was statistically significant（x2=5.08, 14.08, P〈0.05）. The rates of TMPG grade Ⅲ in the observation group were 60.26%and 74.36%, respectively, both higher than 28.84%and 45.19%in the control group, and the difference was statistically significant（x2=7.24, 9.31, P 〈 0.05）. The first cTFC after drug injection and the last cTFC after PCI surgery in the observation group were（37.75±7.02） frames and（27.03±6.52） frames, respectively, both higher than （51.52±9.53） frames and（42.40±8.52） frames in the control group, and the difference was statistically significant （t=11.50, 12.32, P〈0.05）. Conclusion Application of tifofiban through intracoronary ultrasound can significantly improve coronary flow and perfusion of myocardial tissue, thus reducing the incidence of no-flow phenomenon after PCI surgery. It is worthy of wide clinical application.
出处
《中国医药科学》
2014年第14期79-81,90,共4页
China Medicine And Pharmacy
关键词
急性心肌梗死
冠脉内超选择
替罗非班
Acute myocardial infarction
Intracoronary ultrasound
Tirofiban
