【摘要】 目的探讨急性心肌梗死患者行冠状动脉介入治疗中应用血栓抽吸联合冠状动脉内注射替罗非班的临床疗效及其对心功能的影响。方法选取96例急性心肌梗死行急诊冠状动脉介入治疗的患者,其中A组30例仅行经皮冠状动脉介入治疗术,B组34例冠状动脉介入治疗中使用抽吸导管,C组32例行血栓抽吸联合冠状动脉内注射替罗非班治疗。比较三组术后者血管再通时的血流血管心肌梗死溶栓(TIMI)分级、TIMI心肌灌注(TMPG)分级、心电图ST段回落、心肌酶学的变化、左室射血分数、左室重构指数等。结果 3组临床基本资料和冠状动脉造影结果无明显差异(P>0.05)。C组TIMI 3级、TMPG 3级、心电图ST段回落超过50%的比例、左室射血分数、左室重构指数均显著高于A组和B组,CK-MB峰值及达峰时间均明显低于A组和B组,差异均有统计学意义(P<0.05)。B组较A组TIMI 3级、TMPG 3级、心电图ST段回落超过50%的比例、CK-MB峰值及达峰时间有显著差异(P<0.05),而左室射血分数、左室重构指数二者无明显差异(P>0.05)。结论血栓抽吸联合冠状动脉内注射替罗非班PCI术不仅可以改善急性心肌梗死患者冠状动脉血流再灌注,还可以提高患者左心室功能,抑制心室重构。更多还原

【Abstract】 Objective To explore left ventricular function and therapeutical effect of thrombus- aspiration combined with intracoronary Tirofiban Injection during percutaneous coronary intervention on the patients with acute myocardial infarction. Methods Ninety- six patients with acute myocardial infarction performed by percutaneous coronary intervention( PCI) were divided into three groups:group A treated by PCI(30 cases),group B treated by PCI plus thrombus-aspiration( 34 cases),group C treated by PCI plus thrombus- aspiration combined with intracoronary Tirofiban Injection( 32 cases). The thrombolysis in myocardial infarction( TIMI) flow,TIMI myocardial perfusion grade( TMPG),50% resolution of ST- segement elevation,CK- MB,peak- time of CK- MB,left ventricular ejection fraction( LVEF),left ventricular remodeling index( LVRI) were compared among three groups. Results There were on significant differences on basic characteristics and the results of PCI among three groups. Compared with group A and B,the rates of TIMI- 3 flow,TMPG- 3,resolution of ST- segement elevation,LVEF,LVRI were higher in group C,but lower CK- MB and peak- time of CK- MB( P <0.05). There were higher rates of TIMI-3 flow,TMPG-3,resolution of ST- segement elevation in group B than those in group A( P < 0. 05). The difference of LVEF and LVRI showed no statistical differences between group A and B( P> 0. 05). Conclusion Thrombus- aspiration combined with intracoronary Tirofiban Injection during percutaneous coronary intervention on the patients with acute myocardial infarction was not only associated with better myocardial reperfusion,but also improved the left ventricular function and inhibit left ventricular remodeling.更多还原