Lei Zhang, Xiaoming Zhong, Yan Hong, Ming Zhong Xiao
Cardiovascular Department of Huaihe Hospital of Henan University 475000, China.
Open Med (Wars). 2015 Dec 17;10(1):382-387. doi: 10.1515/med-2015-0065. eCollection 2015.
This study is a comparative analysis of the best timing for applying tirofiban in the PCI emergency treatment for STEMI patients. We selected 109 patients with ST-segment elevation myocardial infarction from October 2013 to October 2014 and divided them into two groups, the early treatment group (53 cases) received tirofiban during the operation and the later treatment group (56 cases) received tirofiban after operation. The analysis was then conducted.
The proportion of IRA forward flow in TIMI2-3 for the 1st group during the radiography was higher than 2nd group, 50 cases with TIMI3 blood flow and 52 cases with TIMI3 blood flow in later treatment group. Comparing the TIMI3 flow of both groups, the difference was not statistically significant; for the CK-MB 4h and 8h after operation as well as the LVEF after operation, the differences are were not statistically significant. The occurrence rate of hemorrhage complication was low for both groups. The early use of tirofiban can make the thrombus fully dissolve and coronary blood flow remains in a good state, which is not only beneficial for myocardial perfusion but also helpful for deciding the length and side branch situation of coronary artery pathological changes.
本研究是对替罗非班在ST段抬高型心肌梗死(STEMI)患者PCI急诊治疗中最佳应用时机的比较分析。我们选取了2013年10月至2014年10月期间109例ST段抬高型心肌梗死患者,将其分为两组,早期治疗组(53例)在手术过程中接受替罗非班治疗,后期治疗组(56例)在手术后接受替罗非班治疗。然后进行分析。
造影时第1组IRA前向血流TIMI2 - 3级的比例高于第2组,早期治疗组有50例TIMI3级血流,后期治疗组有52例TIMI3级血流。比较两组的TIMI3级血流,差异无统计学意义;术后4小时和8小时的CK - MB以及术后的LVEF,差异均无统计学意义。两组出血并发症发生率均较低。早期使用替罗非班可使血栓充分溶解,冠状动脉血流保持良好状态,这不仅有利于心肌灌注,也有助于判断冠状动脉病变的长度和分支情况。