The Clinical Efficacy of the Thrombus Aspiration Catheter Combined with Tirofiban Hydrochloride in theInterventional Treatment of Acute Myocardial Infarction
Abstract: Objective To evaluate the clinical application of GPⅡb/ Ⅲa receptor antagonist (Tirofiban hydrochloride injection)combined with the thrombus aspiration catheter in the percutaneous coronary intervention(PCI) treatment for acute myocardial infarction (AMI). Methods From January 2012 to October 2018, 80 patients with AMI planned for PCI treatments in our department were randomly divided into 2 groups, with 40 cases in each. Group A received PCI following thrombus aspiration catheter insertion and tirofiban hydrochloride injection. Group B received PCI following heparin anti-coagulation. Results In group A, stents were implanted in 35 cases after catheter suction. 5 cases who were injected with tirofiban returned to normal blood flow with mild stenosis and had no stents inserted after thrombus aspiration. And only 2 cases appeared no reflow phenomenon. In group B, 10 cases appeared no reflow phenomenon(P<0.05) after balloon expansion or stent implantation. In group A, the levels of CK-MB and TnI were lower than that of the control group(P<0.05). The incidence of malignant arrhythmia, cardiac death and recurrent myocardial infarction in group A were lower than that of the control group (P<0.05). Conclusion In the course of emergency PCI operation, thrombus aspiration catheter combined with Tirofiban hydrochloride injection can obviously reduce the incidence of no reflow phenomenon, reduce the occurrence of MACE, increase the myocardial perfusion and improve the clinical prognosis.
罗蓉，朱新林，杨雯婷. 抽吸导管联合盐酸替罗非班在PCI治疗急性心肌梗塞中的临床疗效研究[J]. 中国现代手术学杂志, 2018, 22(2): 133-136.
LUO Rong. The Clinical Efficacy of the Thrombus Aspiration Catheter Combined with Tirofiban Hydrochloride in theInterventional Treatment of Acute Myocardial Infarction. Chinese Journal of Modern Operative Surgery, 2018, 22(2): 133-136.
[1] Stone GW, Maehara A, Witzenbichler B, et al. Intracoronary abciximab and aspiration thrombectomy in patients with large anterior myocardialinfarction: the INFUSE-AMI randomized trial[J]. JAMA, 2012 ,307(17):1817-1826. doi: 10.1001/jama.2012.421.|[2] 中华心血管病委员会. 急性心肌梗塞诊断和治疗指南[J]. 中华心血管病杂志，2001，29(12):713-714.|[3] 赵树武， 张凯， 徐林东. 血栓抽吸联合经皮冠状动脉介入术治疗ST段抬高型心肌梗死的临床效果及安全性分析[J]. 实用心脑肺血管病杂志，2016，24(3):115-116.|[4] 朱红涛， 刘学庆， 丁晓军， 等. 急性ST段抬高型心肌梗死患者经抽吸导管冠脉内局部推注替罗非班的疗效研究[J]. 中国循证心血管医学杂志，2017，9(6)：728-741.|[5] 中华医学会心血管病学分会， 中华心血管病杂志编辑委员会. 急性ST段抬高型心肌梗死诊断和治疗指南[J]. 中华心血管病杂志，2010，38(8):675-687.|[6] 中华医学会心血管病委员会, 中华心血管病杂志编辑委员会. 中国经皮冠状动脉介入治疗指南 2012(简本)[J]. 中华心血管病杂志,2012,40(4):271-277.|[7] 洪涛. 冠状动脉TIMI 血流分级[J]. 中国介入心脏病学杂志，2003，11 (3 )：154.|[8] 陈亭杰， 杨锋. PCI 患者术后即刻心肌血流储备分数和脑钠尿肽水平对患者预后的影响[J]. 中国心血管病研究，2016，14(1)：42-44.|[9] 赵向利. 关于冠脉介入治疗术中无复流研究的进展[J]. 心血管康复医学杂志，2014，23(6)：688-691.|[10] Kaul S.The "no reflow" phenomenon following acute myocardial infarction: mechanisms and treatmentoptions[J]. J Cardiol， 2014，64(2):77-85. doi: 10.1016/j.jjcc.2014.03.008.|[11] 刘如晨， 徐争鸣. Angiojet 血栓抽吸导管在急性ST段抬高型心肌梗死中的应用研究[J]. 中国全科医学， 2016，19(12)：1472-1475.|[12] Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC), Steg PG, James SK, et al. ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation[J].Eur Heart J, 2012,33(20):2569-2619. doi: 10.1093/eurheartj/ehs215.|[13] 朱新林. 替罗非班对急性心肌梗死患者急诊PCI术中TIMI血流的影响[J]. 中国现代手术学杂志, 2010,14(6)：426-428.|[14] Hara M, Saikawa T, Tsunematsu Y, et al. Hara M, Saikawa T, Tsunematsu Y,et al.Predicting no-reflow based on angiographic features of lesions in patients with acute myocardialinfarction[J]. J Atheroscler Thromb, 2005,12(6):315-321.|[15] Candemir B, Kilickap M, Ozcan OU, et al. Intracoronary versus intravenous high-dose bolus plus maintenance administration of tirofiban in patients undergoing primary percutaneous coronary intervention for acute ST elevationmyocardial infarction[J]. J Thromb Thrombolysis, 2012,34(1):65-72. doi: 10.1007/s11239-012-0685-y.|[16] 江宏飞, 王焱, 黄卫斌, 等. 抽吸导管在急性心肌梗塞患者急诊经皮冠脉介入治疗中的应用[J]. 心血管康复医学杂志,2010,19(1):68-70.|[17] 宗振方， 董平栓. 急性心肌梗死PCI术中慢血流或无复流现象的防治现状[J]. 河南科技大学学报医学版，2013，32(1):73-78.
2018, Vol. 22 
