| 陈 波,王国宏,陈 喆,张福庄,杨 毅.经血栓抽吸导管应用替罗非班及硝普钠对急性前壁ST段抬高型心肌梗死患者急诊PCI治疗效果的影响[J].,2020,(11):2064-2067 |
| 经血栓抽吸导管应用替罗非班及硝普钠对急性前壁ST段抬高型心肌梗死患者急诊PCI治疗效果的影响 |
| Effects of Tirofiban and Sodium Nitroprusside on the Effect of Emergency PCI in Patients with Acute Anterior ST Segment Elevation Myocardial Infarction Treated with Thrombus Aspiration Catheter |
| 投稿时间：2019-11-23 修订日期：2019-12-19 |
| DOI：10.13241/j.cnki.pmb.2020.11.012 |
| 中文关键词: 血栓抽吸 替罗非班 硝普钠 急性前壁ST段抬高型心肌梗死 经皮冠状动脉介入 疗效 |
| 英文关键词: Thrombus aspiration catheter Tirofiban Sodium nitroprusside Acute anterior ST segment elevation myocardial infarction Percutaneous coronary intervention Efficacy |
| 基金项目:北京市2017年保健科研基金项目（京17-16） |
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| 中文摘要: |
| 摘要 目的：探讨经血栓抽吸导管应用替罗非班及硝普钠对急性前壁ST段抬高型心肌梗死患者急诊经皮冠状动脉介入（PCI）治疗效果的影响。方法：选取2013年5月~2018年5月期间我院收治的急性前壁ST段抬高型心肌梗死患者80例，根据随机数字表法分为对照组（n=40，血栓抽吸术后行PCI治疗）和研究组（n=40，血栓抽吸术后，经导管注入替罗非班及硝普钠后再行PCI治疗），比较两组患者心电图ST段回落变化、心肌梗死溶栓治疗（TIMI）血流分级情况、心功能指标及不良心血管事件发生率。结果：研究组完全回落发生率高于对照组（P<0.05）；两组部分回落、无回落发生率比较差异无统计学意义（P>0.05）。对照组PCI术后TIMI血流分级为3级的例数少于研究组（P<0.05）。两组患者术后7 d左室收缩末期内径 (LVESD) 、左室舒张末期内径(LVEDD)降低，且研究组低于对照组（P<0.05）；左室射血分数(LVEF)升高，且研究组高于对照组（P<0.05）。术后6个月内研究组不良心血管事件总发生率为7.50%（3/40），低于对照组的25.00%（10/40）（P<0.05）。结论：急性前壁ST段抬高型心肌梗死患者经血栓抽吸导管应用替罗非班及硝普钠后行PCI，可提高心功能、心肌灌注状态及心电图ST段完全回落率，并减少不良心血管事件的发生率。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect of tirofiban and sodium nitroprusside on the emergency percutaneous coronary intervention (PCI) in patients with acute anterior ST segment elevation myocardial infarction treated with thrombus aspiration catheter. Methods: From May 2013 to May 2018, 80 patients with acute anterior wall ST segment elevation myocardial infarction in our hospital were selected, they were divided into control group (n=40, PCI after thrombus aspiration) and study group (n=40, PCI after combining tirofiban and sodium nitroprusside after thrombus aspiration) according to the method of random number table. The changes of ST segment depression of electrocardiogram thrombolytic therapy for myocardial infarction (TIMI) blood flow classification, cardiac function index and incidence of adverse cardiovascular events in the two groups were compared. Results: The incidence of complete regression in the study group was higher than that in the control group(P<0.05). There was no significant difference in the incidence of partial regression and no regression between the two groups(P>0.05). The number of patients with TIMI blood flow grade 3 after PCI in the control group was less than that in the study group(P<0.05). The left ventricular end systolic diameter (LVESD) and left ventricular end diastolic diameter (LVEDD) in the two groups at 7d after operation decreased, and those in the study group were lower than those in the control group(P<0.05). The left ventricular ejection fraction (LVEF) increased, and that in the study group was higher than that in the control group(P<0.05). The total incidence of adverse cardiovascular events in the study group at 6 months after operation was 7.50%（3/40）, which was lower than 25.00%（10/40） in the control group (P<0.05). Conclusion: PCI with tirofiban and sodium nitroprusside in patients with acute anterior ST segment elevation myocardial infarction can improve the cardiac function, myocardial perfusion status and ST segment complete fall rate of electrocardiogram, and it cna reduce adverse cardiac events. |
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