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冠状动脉内超选择应用替罗非班在STEMI患者PCI治疗中的应用价值
作者:李文强  余宏斌  朱洪斌  刘前君 
单位:重庆市开州区人民医院 心血管内科, 重庆 405400
关键词:超选择冠状动脉 介入治疗 急性ST段抬高型心肌梗死 临床价值 
分类号:R541.4
出版年·卷·期(页码):2019·47·第一期(17-20)
摘要:

目的:研究冠状动脉内超选择应用替罗非班在急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)中的应用价值。方法:筛选2015年6月至2016年12月期间于我院接受介入治疗的STEMI患者296例,采取随机数字表法分为超选择冠状动脉给药组(A组,91例)、常规冠状动脉给药组(B组,98例)和常规静脉给药组(C组,107例)。比较3组的心肌梗死溶栓后血流分级、ST段抬高回落率及随访3个月内相关临床不良事件的发生率。结果: 3组患者PCI术后TIMI血流分级Ⅲ级率差异有统计学意义(P<0.05),由高至低排列为C组 > B组 > A组;ST段完全回落率A组显著大于B、C组(P<0.05),B、C组之间ST段完全回落率差异无统计学意义(χ2=0.002,P>0.05);术后随访期间,A组相关临床不良事件的发生率明显低于B、C组(P<0.05),而B、C组相关临床不良事件发生率差异无统计学意义(χ2=1.003,P>0.05)。结论:在STEMI患者PCI中,冠状动脉内超选择应用替罗非班可以明显改善冠脉循环,减少术后相关临床不良事件的发生。

Objective: To study the application values of tirofiban utraselection percutaneous coronary intervention(PCI) in patients with ST segment elevation myocardial infarction (STEMI). Methods: A total of 296 patients with STEMI who were treated in our hospital from June 2015 to December 2016 were screened.Using random number table method, the patients were devided into 3 groups:91 patients(group A) were treated with ultraselective coronary artery administration, 91 patients(group B) were treated with conventional coronary artery administration (B group), and 107 patients(group C) were given conventional intravenous administration.The myocardial infarction thrombolytic blood flow classification,ST segment elevation drop rate and the incidence of adverse cardiovascular events during follow-up of3 months were compared among the three groups. Results: There were significant differences in TIMI grade Ⅲ rates of the three groups after PCI,from high to low was group C>group B> group A (P<0.05).The complete regression rate of ST segment of the group A was significantly higher than those of group B and group C(P<0.05), butthere was no significant difference between group B and group C (χ2=0.002, P>0.05).During the follow-up period, the incidence of related clinical adverse events was significantly lower in the group A than the other two groups(P<0.05),while there was no significant difference between the group B and group C (χ2=1.003, P>0.05). Conclusions: The effect of tirofiban utraselection PCI on patients with acute STEMI can significantly improve cardiac function, and reduce the occurrence of postoperative clinical adverse events.

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