目的 探讨替罗非班联合血栓抽吸对ST段抬高型心肌梗死(STEMI)患者直接经皮冠状动脉介入治疗(PCI)术后冠状动脉再灌注及心功能的影响.方法 选取2010年6月-2016年6月在亳州市人民医院行直接PCI的STEMI患者60例,采用随机数字表法分为对照组和研究组,每组30例.两组患者均行常规直接PCI,对照组患者给予替罗非班治疗,研究组患者给予替罗非班联合血栓抽吸治疗.比较两组患者术后冠状动脉TIMI血流分级、术后30 d内主要心脏不良事件(MACE)发生率及术前、术后30 d心功能指标.结果 术后研究组患者冠状动脉TIMI血流分级优于对照组(P<0.05).PCI术后30 d内两组患者MACE发生率比较,差异无统计学意义(P>0.05).两组患者术前和术后30 d脑钠肽(BNP)水平、左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)及术前左心室收缩末期内径(LVESD)比较,差异均无统计学意义(P>0.05);研究组患者术后30 d LVESD短于对照组(P<0.05).术前两组患者T波峰末间期(Tp-e间期)和T波峰末与QT间期比值(Tp-e/QTc比值)比较,差异均无统计学意义(P>0.05);术后30 d研究组患者Tp-e间期短于对照组,Tp-e/QTc比值低于对照组(P<0.05).结论 替罗非班联合血栓抽吸能有效改善STEMI患者直接PCI术后冠状动脉再灌注和心脏收缩功能,降低恶性心律失常发生率,且未增加MACE发生风险.%Objective To explore the impact of tirofiban combined with thrombus aspiration on coronary reperfusion and cardiac function of postoperative STEMI patients treated by primary PCI.Methods A total of 60 STEMI patients undergoing primary PCI were selected in the People′s Hospital of Bozhou from June 2010 to June 2016,and they were divided into control group and study group according to random number table,each of 30 cases.Patients of the two groups received primary PCI,meanwhile patients of control group received tirofiban,while patients of study group received tirofiban combined with thrombus aspiration.Coronary TIMI flow grade after PCI,incidence of major adverse cardiac events(MACE)within 30 days after PCI,index of cardiac function before and after PCI were compared between the two groups.Results Coronary TIMI flow grade of study group was statistically significantly better than that of control group immediately after PCI(P<0.05).No statistically significant differences of incidence of MACE was found between the two groups within 30 days after PCI(P>0.05).No statistically significant differences of BNP,LVEDD or LVEF was found between the two groups before or after PCI,nor was LVESD between the two groups before PCI(P>0.05),while LVESD of study group was statistically significantly shorter than that of control group after PCI(P<0.05).No statistically significant differences of Tp-e interval or Tp-e/QTc ratio was found between the two groups before PCI(P>0.05);after 30 days of PCI,Tp-e interval of study group was statistically significantly shorter than that of control group,while Tp-e/QTc ratio of study group was statistically significantly lower than that of control group(P<0.05).Conclusion Tirofiban combined with thrombus aspiration can effectively improve the coronary reperfusion and cardiac contractile function of postoperative STEMI patients treated by primary PCI,reduce the risk of malignant arrhythmia without increasing the risk of MACE.
展开▼
