【摘要】 目的:评价血小板Ⅱb/Ⅲa受体拮抗剂替罗非班经冠状动脉注射对急性ST段抬高型心肌梗死(STEMI)患者急诊经皮冠状动脉介入(PCI)治疗后无再流的疗效。方法:STEMI急诊经皮经腔冠状动脉成形术/支架置入术梗死相关动脉再通后存在无再流现象50例。2005-01-2007-10,20例冠状动脉内注射硫氮唑酮(0.5～2.0mg),2007-11-2010-03,30例冠状动脉内注射替罗非班(0.5～1.0mg);注射完后10min行冠状动脉造影,评定冠状动脉血流TIMI分级。结果:硫氮唑酮组应用后20～40min内TIMI血流3级10例,TIMI血流0～2级10例;替罗非班组应用后20～40min内TIMI血流3级24例,TIMI血流0～2级6例。达TIMI3级患者替罗非班组多于硫氮唑酮组(P<0.05)。结论:经冠状动脉给予替罗非班(0.5～1.0mg)后能有效改善急诊PCI术中无再流现象。更多还原

【Abstract】 Objective:To assess the effects of intracoronary administration of tirofiban in the patients with acute ST-elevation myocardial infarction(STEMI) that had no reflow phenomenon of infarct related artery(IRA) after primary percutaneous transluminal coronary angioplasty or/and intracoronary stenting.Method:We studied 50 AMI patients with no reflow phenomenon of IRA after emergent PCI between January 2005 and March 2010.Diltiazem treated group(n=20) was given intracoronary diltiazem 0.5～2.0 milligram with 10～30 minutes between January 2005 and October 2007,while tirofiban treated group(n=30) was given intracoronary tirofiban 0.5～1.0 milligram with 10～30 minutes between November 2007 and March 2010.Ten minutes after administration,coronary arteriography(CAG) was performed and thrombolysis in myocardial infarction(TIMI) flow grade was measured.Result:50% of patients in the diltiazem treated group reached TIMI flow grade 3 within 20～40 minutes;80% of patients in the tirofiban treated group reached TIMI flow grade 3.The percentage of the patients who reached TIMI flow grade 3 after the intracoronary administration was significantly higher in the tirofiban treated group as compared to diltiazen treated group(P<0.05).Conclusion:The intracoronary administration of tirofiban 0.5～1.0 milligram can effectively improved the no reflow phenomenon after primary PCI in patients with STEMI.更多还原