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目的:评价血小板Ⅱb/Ⅲa受体拮抗剂替罗非班经冠状动脉注射对急性ST段抬高型心肌梗死(STEMI)患者急诊经皮冠状动脉介入(PCI)治疗后无再流的疗效。方法:STEMI急诊经皮经腔冠状动脉成形术/支架置入术梗死相关动脉再通后存在无再流现象50例。2005-01-2007-10,20例冠状动脉内注射硫氮唑酮(0.5～2.0mg),2007-11-2010-03,30例冠状动脉内注射替罗非班(0.5～1.0mg);注射完后10min行冠状动脉造影,评定冠状动脉血流TIMI分级。结果:硫氮唑酮组应用后20～40min内TIMI血流3级10例,TIMI血流0～2级10例;替罗非班组应用后20～40min内TIMI血流3级24例,TIMI血流0～2级6例。达TIMI3级患者替罗非班组多于硫氮唑酮组(P<0.05)。结论:经冠状动脉给予替罗非班(0.5～1.0mg)后能有效改善急诊PCI术中无再流现象。
Objective: To evaluate the efficacy of no-reflow after platelet Ⅱ b / Ⅲa receptor antagonist transrenal coronary intervention in acute ST-segment elevation myocardial infarction (STEMI) patients undergoing percutaneous coronary intervention (PCI). Methods: There were 50 cases of no reflow phenomenon after STEMI emergency percutaneous transluminal coronary angioplasty / stent placement. Intravenous injection of tazobactam (0.5 ~ 2.0mg), 2007-11-2010-03, 30 cases of intracoronary injection of tirofiban (0.5 ~ 1.0mg); Coronary angiography was performed 10 min after injection, and TIMI grade of coronary blood flow was evaluated. Results: TIMI blood flow was grade 3 in 20 to 40 min after thiazolidinone group and 10 in TIMI blood flow in grade 0 to 2. Twenty-four TIMI blood flow grade 3 in Tirofiban group within 20 ~ 40 min after operation, TIMI Blood flow 0 to 2 6 cases. Tirofiban was higher in patients with TIMI3 than in patients receiving daroxofen (P <0.05). CONCLUSION: Tirofiban (0.5-1.0 mg) administered via coronary artery can effectively improve the no-reflow phenomenon during emergency PCI.