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.doc

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1、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［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20min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TIMI1~2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（

2、P=0.026b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)-057-03ClinicalefficacyofintracoronaryTirofibanforthrombustreatmentindiabetespatientswithem

3、ergencytreatmentPCIQIANHuidong,ZHENGRuolong,CHENXinjun,LIWeizhang,ZHANGHuaDepartmentofCardiology,theAffiliatedJiangyinHospital,CollegeofMedicineofSoutheastUniversity,JiangsuProvince,Jiangyin214400,China［Abstract］Objective:ToexplorethefeasibilityandsafetyindiabetespatientswithemergencytreatmentPCTaf

4、terinjectingTirofibanduringpercutaneuoscoronaryinterventionforthrombustreatment.Methods:33casesofthediabetespatientswithacutethrombusindiabetespatientsduringperecutaneouscoronaryintervention(PCI)weredividedintoTirofibantreatmentgroup(n=18)andconventionaltreatmentgroup(n=d5).Theeventsofcardiovascula

5、rdiseases(CVD)withinonemonthwerestudiedandcompared・ThebloodstreamofcoronarywascomparedafterinjectingTirofiban.Results:ThebloodstreamofcoronaryTIMIgrade1to2was3casesinTirofibantreatmentgroupandwas8casesinthecontrolgroup.TheCVDeventswas3casesinTirofibantreatmentgroupandwas8casesincontrolgroup（P=0.026

6、）.Conclusion:InjectingTirofibanduringpercutaneuoscoronaryinterventionforthrombustreatmentindiabetespatientsisfeasibilityandsafety.ThebloodstreamofcoronarycanbeimprovedafterinjectingTirofiban.Andcanreaduethecoronaryarterystenosisrate,theCVDaftersurgeryonemonth,alsocouldnotincreasethecomplications,su

7、chasbleeding,hematomaandthecardiovascularcomplicationsbytheDMpatientswithPCT.[Keywords]Diabetes;Emergencytreatment;Percutaneuoscoronaryintervention;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AM