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目的探讨急性ST段抬高心肌梗死患者急诊直接经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)应用靶向灌注导管行梗死相关血管(infarct-related artery,IRA)逆向用药防治冠状动脉慢/无复流研究中小球囊低压力预扩张对其疗效的影响。方法回顾性分析46例急性ST段抬高心肌梗死患者在直接PCI前均应用靶向灌注导管行IRA靶病变远端逆向注射血小板糖蛋白Ⅱb/Ⅲa抑制剂替罗非班、硝酸甘油,根据在IRA逆向用药前靶病变处是否行球囊预扩张分为预扩张组(21例)和未行预扩张组(25例),比较两组的临床资料、术中慢/无复流现象发生率,并观察住院期间主要心血管事件。结果预扩张组患者慢/无复流的发生率9.5%,主要心脏事件发生率9.5%;未行预扩张组患者慢/无复流发生率8%,主要心脏事件发生率12%。结论两组患者慢/无复流和不良心血管事件发生率无明显差别,急性ST段抬高心肌梗死患者经靶向灌注导管行IRA远端逆向用药前IRA靶病变处小球囊低压力预扩张不增加慢/无复流的发生,不影响直接PCI治疗结果。
Objective To investigate the effects of reverse medication on infarct-related artery (IRA) in patients with acute ST-segment elevation myocardial infarction undergoing emergency percutaneous coronary intervention (PCI) The Effect of Low Pressure Premature Dilatation of Small Balloon Vessels on the Curative Effect in Reflux Study. METHODS: Tirofiban and nitroglycerin were retrospectively analyzed in 46 patients with acute ST-segment elevation myocardial infarction who were treated with targeted perfusion catheter and reverse-injected with platelet glycoprotein Ⅱb / Ⅲa. The pre-dilatation of IRA was divided into pre-dilatation group (n = 21) and pre-dilatation group (n = 25). The clinical data of two groups were compared. The incidence of slow / no-reflow , And observed the main cardiovascular events during hospitalization. Results The rate of slow / no-reflow in pre-dilatation group was 9.5%, and the incidence of major cardiac events was 9.5%. The rate of slow / no-reflow in patients without pre-dilation was 8% and the incidence of major cardiac events was 12%. Conclusions There is no significant difference between the two groups in the incidence of slow / no-reflow and adverse cardiovascular events. In patients with acute ST-segment elevation myocardial infarction, the low pressure preconditioning Expansion does not increase the occurrence of slow / no reflow, does not affect the results of direct PCI.