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目的:观察血栓抽吸导管联合冠状动脉内注射替罗非班对急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)中的疗效及安全性。方法:选择符合条件的AMI患者340例,均行急诊PCI,PCI术中应用血栓抽吸联合冠状动脉内注射替罗非班的180例患者作为观察组,直接行PCI的160例患者作为对照组,观察2组术后冠状动脉血流灌注水平(TIMI分级)、心肌灌注水平(TMP分级),无复流或慢血流发生率,住院期间再梗死、梗死相关血管再次血运重建、心力衰竭发生率、30d内的死亡率、出血等并发症发生率。结果:观察组在术后冠状动脉血流灌注水平、心肌灌注水平均较对照组升高,而无复流或慢血流发生率则明显减少;观察组在住院期间再梗死、目标血管再次血运重建、心力衰竭发生率、30d内的死亡率等方面,与对照组比较差异有统计学意义(P<0.05)。2组在出血等并发症发生率方面比较,差异无统计学意义(P>0.05)。结论:AMI患者行急诊PCI过程中,应用血栓抽吸导管联合冠状动脉内注射替罗非班可明显减少慢血流、无复流等并发症的发生,从而降低病死率,改善近期预后,是一种安全有效的治疗方法。
Objective: To observe the efficacy and safety of thrombus aspiration catheter combined with intracoronary injection of tirofiban for percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI). Methods: A total of 340 eligible patients with AMI were enrolled in this study. All of the 180 patients undergoing PCI for PCI were treated with thrombus aspiration and PCI with tirofiban in their coronary artery. PCI was performed in 160 patients as control group (TIMI grade), myocardial perfusion level (TMP grade), incidence of no-reflow or slow blood flow, reinfarction during hospitalization, revascularization of infarct-related blood vessel, heart failure Incidence, mortality within 30 days, bleeding and other complications. Results: The level of coronary perfusion and myocardial perfusion in the observation group were significantly higher than those in the control group, while the rate of no-reflow or slow blood flow was significantly decreased in the observation group. The observation group re-inflated during hospitalization and the target blood re-blood Transport reconstruction, the incidence of heart failure, the mortality within 30d and so on, compared with the control group, the difference was statistically significant (P <0.05). There was no significant difference between the two groups in the incidence of complications such as bleeding (P> 0.05). Conclusions: Thrombus aspiration catheter combined with intracoronary injection of tirofiban can significantly reduce the incidence of complications such as slow blood flow and no-reflow during the emergency PCI in patients with AMI, thus reducing the mortality and improving the short-term prognosis. A safe and effective treatment.