【摘要】 目的探讨替罗非班、腺苷在急性ST段抬高型心肌梗死患者行经皮冠状动脉介入(PCI)术中围术期的应用价值。方法选择2010~2011年本院急性ST段抬高型心肌梗死患者行急诊PCI术,选择应用替罗非班、腺苷组及对照组各25例,行介入治疗者,腺苷140μg/(kg.min)静脉推入,于术前6 min内推完。股动脉穿刺完毕后,静脉内推注替罗非班(tirofiban)10μg/kg,3 min推完,后以0.15μg/(kg.min)于24 h匀速静脉泵入。结果行PCI术的患者中用替罗非班、腺苷组冠脉血流恢复达TIMI 3级者比例更高。术后半年复查LVEF(左心室射血分数)、CI(心脏指数)、SVI(每搏指数)增加,LVEDV(左心室舒张末期容积)、LVESV(左心室收缩末期容积)减少(P<0.05)。结论急性ST段抬高型心肌梗死介入治疗围术期联合盐酸替罗非班和腺苷有助于改善无复流,有助于患者心功能的改善。更多还原

【Abstract】 Objective To explore the value of tirofiban combined with adenosine in acute ST-segment elevation myocardial infarction patients who undergo percutaneous coronary intervention(PCI) in the perioperative period.Methods Fifty patients who received PCI surgery between 2010 to 2011 were randomly divided into treatment group(n=25) and control group(n=25).In the treatment group,adenosine was used before PCI surgery [140 μg/(kg·min)],intravenous injection within 6 min),and tirofiban was used after femoral artery puncture(10 μg/kg intravenous injection within 3 min followed by 0.15 μg/(kg·min) intravenous infusion in 24 hours).Results There were more patients with flow rate over TIMI Ⅲ in the treatment group who received PCI surgery and tirofiban and adenosine.Six months after PCI,left ventricular ejection fraction,cardiac index,stroke volume index significantly increased,and left ventricular end diastolic volume,left ventricular end systolic volume significantly decreased in the treatment group(P<0.05).Conclusion Application of tirofiban combined with adenosine during PCI in patients with acute st-segment elevation myocardial infarction can reduce the occurrence of no-reflow and improve cardiac function.更多还原