糖尿病患者急诊PCI时冠状动脉内注射国产替罗非班治疗支架内急性血栓(1)
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[摘要] 目的：探讨糖尿病(DM)患者急诊经皮冠状动脉介入治疗(PCI)时冠状动脉内注射国产替罗非班对支架内急性血栓的治疗作用及对预后的影响。方法：回顾性分析33例在急诊PCI时冠状动脉内有急性血栓的DM患者，分为术中应用替罗非班治疗组(18例)，对照组为术中未应用替罗非班组(5例)，比较两组用药20 min后冠状动脉造影情况，随访术后即刻及1个月内心血管事件的发生情况。结果：替罗非班治疗组冠状动脉注射替罗非班后造影示，梗死血管TIMI 1～2级3例，对照组8例(P=0.026)， 术后1个月替罗非班治疗组心血管事件3例，对照组8例(P=0.026)。结论：DM患者急诊PCI时急性冠状动脉内血栓采用冠状动脉内注射替罗非班能迅速改善冠状动脉血流，减少术后即刻冠状动脉狭窄率及术后1个月内心血管事件，不增加出血、血肿等与穿刺相关并发症及脑出血等其他并发症，能明显减少DM患者急诊PCI后心血管并发症。
[关键词]糖尿病；急诊；经皮冠状动脉介入治疗；替罗非班；血栓
[中图分类号] R587.1[文献标识码]A [文章编号]1673-7210(2011)07(c)-057-03
Clinical efficacy of intracoronary Tirofiban for thrombus treatment in diabetes patients with emergency treatment PCI
QIAN Huidong, ZHENG Ruolong, CHEN Xinjun, LI Weizhang, ZHANG Hua
Department of Cardiology, the Affiliated Jiangyin Hospital, College of Medicine of Southeast University, Jiangsu Province, Jiangyin 214400, China
[Abstract] Objective: To explore the feasibility and safety in diabetes patients with emergency treatment PCT after injecting Tirofiban during percutaneuos coronary intervention for thrombus treatment. Methods: 33 cases of the diabetes patients with acute thrombus in diabetes patients during perecutaneous coronary intervention (PCI) were divided into Tirofiban treatment group (n=18) and conventional treatment group (n=15). The events of cardiovascular diseases (CVD) within one month were studied and compared. The blood stream of coronary was compared after injecting Tirofiban. Results: The blood stream of coronary TIMI grade 1 to 2 was 3 cases in Tirofiban treatment group and was 8 cases in the control group. The CVD events was 3 cases in Tirofiban treatment group and was 8 cases in control group (P=0.026). Conclusion: Injecting Tirofiban during percutaneuos coronary intervention for thrombus treatment in diabetes patients is feasibility and safety. The blood stream of coronary can be improved after injecting Tirofiban. And can readue the coronary artery stenosis rate, the CVD after surgery one month, also could not increase the complications, such as bleeding, hematoma and the cardiovascular complications by the DM patients with PCT.
[Key words] Diabetes; Emergency treatment; Percutaneuos coronary intervention; Tirofiban; Thrombus
冠状动脉内急性血栓形成是急性心肌梗死(AMI)的主要原因，糖尿病(DM)患者AMI后，冠脉内大量血栓形成常是AMI急诊介入治疗过程中较为棘手的问题，微小血栓形成或斑块脱落导致远端血管栓塞常会产生“无复流”或“慢复流”现象，从而影响急诊介入治疗的疗效。本研究通过冠状动脉内注射国产血小板糖蛋白Ⅱb/Ⅲa受体拮抗剂(替罗非班)(欣维宁)治疗在急诊经皮冠状动脉介入治疗(PCI)时 ......
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