学2014,Sep;42(9):1007-1010•论著•替罗非班联合血栓抽吸对急诊PCI患者的近期疗效观察赵玉勒，何家富，李彬，吴校林，未锐，刘文卫(湖北文理学院附属医院，襄阳市中心医院心内科，湖北襄阳441021)闻耍］目的：观察替罗耳班联合血栓抽吸对急性ST段抬高型，过肌梗死(STEM!)行急诊PCI患者的近期疗效。方V去.选择行急诊PCI术的STEMI患者68例，梗死相关血管(IRA血流TIMI01级。莫中37例行替罗非”王联合血栓抽吸(血栓抽吸纽)，另外31例经传统方法完成PCI术(传统PCI纽)。比较两纽患者IRA的TIMI血流分级、无复流朋血流发生率、术中术后并发症及术后30d内主要心脏不良事件IMACE发生率。结果.与传统PCI纽相比,血栓抽吸纽再灌注心律失常、出fiL、血用等术中及术后并发症并没有减少(P>0.05)o但血栓才由吸纽IRA术后TIMI血流分级明显高于传统PCI纽IPV0.()5：,元复流很血流发生率、球爱使川例数及术后30d部分MACE发牛率低于传统PCI组，•差异有统计学意义(P<0.()5)。结论•替罗非班联合血栓才由吸能够改善STEMI患者急诊PCI术后IRA血流，降低元复流/慢血沛现象及近期MACE的发生率，显著改善STEMI患者的近期预后。E关键词］急性ST段抬高型，丄卯膨匕，急诊经皮冠状动脉介入治疗，替罗非班，血栓抽吸［中图分类号］R542.22t文献标识码JAt文章编号］1671习562(2014)09-1007-04doi:10.3969/j-issn.1671-7562.2014.09.010TermefficacyoftirofibancombinethrombusaspirationinpatientsundergoemergencyPCIZHAOYu-qin,HEJia斗li,LIBin,WUXiao斗in.ZHURui,LIUWen寸Nei(DepartmentofCardiology,XiungyangCenlraiHospital.AjjiliaLedHospitalofHube,UniversityofAlisandScience,Xiangyang441021,China)(Abstract］Objective:TostudythetermefficacyoftirofibancombinethrombusaspirationinpatientswithacuteSTnJegmenlelevationmyocardialinfarction(STEM!)undergoemergencypercutaneouscoronaryintervention(PCI)・Methods:Sixty-eightpatientswithSTEMIreceivedemergencyPCIwereselected.Alltheinfarct、」elatedcoronaryarteries(IRA)flowwasTIMI0-1grade・Thirtyfevenpatientsinthethrombusaspirationgroupreceivedtirofibanandthrombusaspiration,Otherthirty-onepatientsintheconventionalPCTgroupreceivedroutinePCT.TIMIbloodflow,norefloworslowflowincidenceofIRAafterPCLintraoperativeandpostoperativecomplicationsandmajorcardiacadverseevent(MACE)within30daysinthetwogroupswerecompared・Results:ComparedwiththeconventionalPCIgroup、intraoperativeandpostoperativecomplications(suchasreperfusionarrhythmias,bleeding,收稿日期］20131029修回日期］2014-05-04申者简介1赵玉到U(1973斗，女湖北襄阳人，主管护师。E寸nail:zyq7310@126a.comDililg作£］何家富E弓nail:jiafu1079@sma.com口文格式i赵玉勤，傢富,李瞬替罗非班联合血栓抽吸对急诊PCJ®者的近期疗效观察团现代医学,2014,42(9):10071010hematoma,etc・)inthethrombusaspirationgroupdidntreduce(P>0.05)・ButthegradeofIRATIMIbloodflowinthethrombus-aspirationgroupwassignificantlyhigherthanthatoftheconventionalPCIgroup(P<0.05)・Inaddition、theincidenceofnorefloworslowflow,numbersofpatientsusingballoonandpartlyMACEoccurrenceinthethrombusaspirationgroupwassignillcanllylowerthanthatoftheconventionalPCIgroupwithin30days(P<0.05)・Conclusion・TirofibancombinethrombusaspirationcanimproveIRAbloodflowandreduceno-reflow/slow寸lowphenomenoninSTEM!patientsafteremergencyPCLalsocandecreaserecentincidenceofMACEandsignificantlyimprovetermprognosisofpatientswithSTEM!.[Keywords]acuteST-segmentelevationmyoca凶alinfarction,emergencypercutaneouscoronaryintervention'tiroflban、thrombusaspiration急诊经皮冠状动脉介入治疗(percutaneot/scoronaryintervention,PCI)是治疗急性ST段抬高型心JI儿死(ST-segmentelevatedacutemyocardialm的预匠，降低致残率和死】'「率1O但山斑块破裂、脱落...