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目的观察经导管冠状动脉血栓抽吸(PT)术联合替罗非班用于急性ST段抬高型心肌梗死(ASTEMI)的疗效。方法将ASTEMI患者随机分为单纯经皮冠状动脉腔内成形术(PCI)组(C组)和PCI+PT联合应用替罗非班组(A组)。C组实施常规球囊扩张术后置入支架;A组加用经导丝直接送入ZEEK血栓抽吸导管至病变部位,反复抽吸至血栓影消失,梗死部位恢复前向血流后注入替罗非班,并置入冠脉内支架。比较两组梗死相关血管(IRA)的血流和心肌灌注、ST回落率、直接支架率,并随访住院期间及出院后心功能及心血管事件。结果 A组抽吸导管均通过病变,血栓抽吸后即刻血栓影消失或明显减少,前向血流恢复、梗死部位心肌组织的再灌注及ST回落率、直接支架率均优于C组。结论 PCI+PT联合注射替罗非班是处理急性冠脉内血栓的一种有效的方法,可以改善ASTEMI患者IRA的血流和心肌功能。
Objective To evaluate the efficacy of transcatheter coronary thrombosis (PT) in combination with tirofiban for acute ST-segment elevation myocardial infarction (ASTEMI). Methods ASTEMI patients were randomly divided into simple percutaneous transluminal coronary angioplasty (PCI) group (group C) and PCI + PT combined with tirofiban group (group A). Group C was treated with conventional balloon dilatation and placed in stents; Group A was treated with ZEEK thrombus aspiration catheter directly into the lesion through Group A, repeated suction until the thrombus disappeared, Luo Fei Ban, and placed coronary stent. The blood flow and myocardial perfusion, ST drop rate, direct stenting rate were compared between the two groups of IRA patients and were followed up for hospitalization and post-discharge cardiac function and cardiovascular events. Results A group of aspiration catheters all passed the lesion. Thrombus disappeared or decreased immediately after thrombus aspiration, and the anterior flow was restored. The myocardial reperfusion, ST-drop rate and direct stent rate in infarction area were better than those in C group. Conclusion PCI + PT combined with tirofiban is an effective treatment for acute coronary thrombosis, which can improve IRA blood flow and myocardial function in ASTEMI patients.