论文部分内容阅读
目的评价GPⅡb/Ⅲa受体拮抗剂盐酸替罗非班在ST段抬高急性心肌梗死(STEMI)急诊经皮冠状动脉腔内介入术(PCI)治疗中的安全性。方法 120例急诊入院STEMI行急诊PCI的患者,随机分为试验组(盐酸替罗非班+PCI)60例和对照组(直接PCI)60例。观察2组住院期间主要心血管事件(MACE)包括死亡、新近心肌梗死和顽固缺血状态、术后左心室射血分数(LVEF)、压迫止血时间及不良反应(出血、血小板减少)。结果住院期间MACE发生率,试验组略高于对照组(10%vs 6.7%,P>0.05);术后LVEF(56.97±8.41vs 54.15±7.11)高于对照组;2组均未发生严重出血并发症(包括大量出血和颅内出血等),出血事件发生率试验组较对照组有增多的趋势(8.3%比3.3%),试验组部分凝血活酶时间(APTT)较对照组延长(53.97±10.58 vs 32.51±6.31,P<0.05);压迫止血时间明显延长(38.16±5.37 vs 21.34±4.96,P<0.05),但未增加穿刺点出血和血肿。结论盐酸替罗非班联合PCI可能成为STEMI患者急诊PCI安全和有效的再灌注手段。
Objective To evaluate the safety of GP IIb / IIIa receptor antagonist tirofiban in the treatment of acute myocardial infarction with ST-segment elevation acute myocardial infarction (STEMI) undergoing percutaneous transluminal coronary angioplasty (PCI). Methods A total of 120 acute STEMI PCI patients were randomly divided into two groups: trial group (tirofiban + 60) and control group (PCI) 60. The main cardiovascular events (MACE) during hospitalization were observed in two groups including death, recent myocardial infarction and intractable ischemia, postoperative left ventricular ejection fraction (LVEF), compression hemostasis time and adverse reactions (hemorrhage, thrombocytopenia). Results The incidence of MACE during hospitalization was slightly higher in the experimental group than in the control group (10% vs 6.7%, P> 0.05). The postoperative LVEF (56.97 ± 8.41 vs 54.15 ± 7.11) was higher than that in the control group. No severe bleeding occurred in the two groups Complications (including massive bleeding and intracranial hemorrhage, etc.), the incidence of bleeding in the test group increased more than the control group (8.3% vs 3.3%), and the experimental group’s partial thromboplastin time (APTT) was longer than the control group (53.97 ± 10.58 vs 32.51 ± 6.31, P <0.05). The compression hemostasis time was significantly longer (38.16 ± 5.37 vs 21.34 ± 4.96, P <0.05), but did not increase the puncture point hematoma. Conclusion Tirofiban combined with PCI may be a safe and effective reperfusion method for emergency PCI in STEMI patients.