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1、ChineseGeneralPractice2(川均月舞P3卷,c簿}·2329··論著·替羅非班聯(lián)合血栓抽吸導(dǎo)管治療急性心肌梗死患者的臨床研究田乃亮,陳紹良,葉飛,常蕓,闞靜,段寶祥【摘要】目的探討替羅非班聯(lián)合血栓抽吸導(dǎo)管治療急性sT段抬高型心肌梗死患者的臨床療效。方法選擇2006年6月—2o08年6月我院住院行急診經(jīng)皮冠狀動(dòng)脈介入(PCI)治療的80例急性sT段抬高型心肌梗死患者,經(jīng)冠狀動(dòng)脈造影證實(shí)為重度血栓負(fù)荷,應(yīng)用替羅非班聯(lián)合血栓抽吸導(dǎo)管治療為A組(4O例),同期未應(yīng)用替羅非班聯(lián)合血栓抽吸導(dǎo)管治療為B組(40例)。
2、比較兩組術(shù)后患者的心肌梗死溶栓(TIMI)血流、TIMI心肌灌注分級(jí)(TMPG)、住院期間MACE及隨訪12個(gè)月時(shí)主要心血管不良事件(MACE)有無(wú)差異。結(jié)果A組TIMI血流3級(jí)及TMPG3級(jí)患者多于B組,差異均有統(tǒng)計(jì)學(xué)意義(P<0.05)。兩組患者院內(nèi)MACE發(fā)生率比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P>0.05)。隨訪12個(gè)月A組患者靶病變血運(yùn)重建(TLR)率、靶血管血運(yùn)重建(TVR)率及總的MACE發(fā)生率低于B組,差異均有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論替羅非班聯(lián)合血栓抽吸導(dǎo)管治療可顯著改善急性sT段抬高型心肌梗死患者TIMI血
3、流、TMPG分級(jí),降低患者12個(gè)月的TLR、TVR及MACE的發(fā)生率?!娟P(guān)鍵詞】心肌梗死;替羅非班;血管成形術(shù),經(jīng)皮冠狀動(dòng)脈【中圖分類號(hào)】R541.4【文獻(xiàn)標(biāo)識(shí)碼】A【文章編號(hào)】1007—9572(2010)07—2329—03EfectofTirofibanCombinedwithThrombusAspirationCatheterTherapyonPatientswithAcuteMyocardialInfarctionTIANNai—liang,CHENShao—liang,YEFei,eta1.Department
4、ofCardiology,theAffiliatedNanjingFirstHospitalofNanjingMedicalUniversity,Nanjing210006,China【Abstract】ObjectiveToinvestigatetheclinicaleffectofTirofibancombinedwiththrombusaspirationcathetertherapyonpatientswithST—segmentelevatuionacutemyocardialinfarction(STEMI).
5、MethodsFromJun2006toJun2008,atotalof80patientswithSTEMIandthromboticburdenlesionconfirmedbycoronaryangiographywhounderwentprimarypercutaneouscoronaryartery(PCI)treatmentwereenrolledinthisstudy,TheyweredividedintogroupArecievingtirofibanwithaspirationcatheter(n=40)
6、,groupBrecievingnotirofibanandaspirationcatheter(n=40).Thenthedifferencesofthrombolysisinmyo—cardialinfarction(TIMI)flowgrade,TIMImyocardialperfusiongrade(TMPG)andmajoradversecardiacevents(MACE)inhospitalandMACEin12monthswerecomparedbetweenthetwogroups.ResultsThen
7、umberofpatientswiththreegradedTIMIflowandTMPGafterthetherapywaslargerinthegroupAthaningroupB(P<0.05).MACEincidenceinhospitalinthepa—tientsofthetwogroupshowednosignificance(P>0.05).The12一monthfollowupshowedthattherateoftargetlesion(TLR)ortargetvesselrevascularizati
8、on(TVR),andthetotalincidenceofMACEofthepatientsingroupAwerelowerthanthoseingroupB(P<0.05).ConclusionCombinationoftirofibanandthrombusaspirationcatheterc