摘要目的 观察国产血小板Ⅱb/Ⅲa受体拮抗剂盐酸替罗非班(欣维宁)治疗急性ST段抬高心肌梗死(STEAMI)行急诊冠脉介入治疗术后无复流和急性血栓的疗效和安全性.方法 40例明确诊断STAMI患者在行急诊PCI支架置入后发生无复流和急性血栓形成,立即给予国产盐酸替罗非班(欣维宁)治疗,先以0.4μg·kg-1·min-1的剂量在3 min内冠状动脉注射,30 min后以0.1 μg·kg-1·min-1的速度静脉泵入维持48 h.结果 无复流及急性血栓在5 min内完全消失,同时经1周的观察未见明显的不良反应.结论 替罗非班冠脉内直接注射联合急诊PCI,可增加急性心肌梗死患者梗死相关血管的开通率,可能成为更安全、有效的再灌注手段.

abstractsObjective To evaluate the efficacy and safety of tirofiban in treatment of ST segment elevation acute myocardial infarction(STEAMI) no-reflow and acute thrombosis after emergency percutaneous coronary intervention(PCI). Methods Forty patients which were made definite diagnosis of STEAMI were intra-coronary artary injection fortirofiban after emergency PCI stenting occured no-reflow and acute thrombosis. First,the dose of 0.4μg·kg-1·min-1 was given from intra--coronary artary injection of tirofiban within three minutes, after 30min the dose were given 0.1μg·kg-1·min-1 for 48 hours. Results The no re-flow and acute thrombosis was completely disappeared within five minutes,at the time,side effect with in one week was not observed. Conclusions Tirofiban treatment by direct injection in coronary arteries combined with emergency PCI, can increase the repeffusion rate of infarction related vessel in AMI patients,and improve TIMI reflow. This reperfusion method was effective and safe.