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杜孟哑.依替巴肽在急性ST段抬高型心肌梗死中的应用及无复流和慢血流中的疗效[J].内科急危重症杂志,2026,32(2):157-161
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| DOI：10.11768/nkjwzzzz20260211 |
| 中文关键词: 急性ST段抬高型心肌梗死 依替巴肽 无复流 慢血流 主要不良心血管事件 |
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| 摘要点击次数: 104 |
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| 中文摘要: |
| 摘要 目的：探讨依替巴肽静脉维持联合经皮冠状动脉介入（PCI）术靶点给药在急性ST段抬高型心肌梗死（STEMI）中的应用及无复流、慢血流中的疗效。方法：选取81例急性STEMI合并高血栓负荷行急诊PCI术的患者为研究对象，根据随机数字表法分为研究组（41例）和对照组（40例）。研究组在PCI术中给予依替巴肽靶点冠脉给药，术后持续静脉维持输注24 h；对照组在PCI术开始时以依替巴肽持续静脉滴注至术后24 h。比较2组患者的心肌灌注及心功能指标，住院期间出血情况，无复流、慢血流及主要不良心血管事件。结果：术后2组患者心电图示ST段均回落，且研究组回落更明显（P均<0.05），血清肌酸激酶同工酶、肌钙蛋白I水平明显下降（P均<0.05）。术后3个月，2组患者的左室射血分数均增加，左室舒张末期内径减少，且研究组患者心功能指标改善更明显（P均<0.05）；术后3个月研究组血浆N-末端B型利钠肽前体下降明显（P均<0.05）。2组中无复流及慢血流均有发生，但研究组无复流、慢血流总发生率较低（P均<0.05）；住院期间2组无大出血患者（P>0.05），研究组主要不良心血管事件总发生率较低（P<0.05）。结论：依替巴肽静脉联合PCI术靶点给药可增加急性STEMI患者心肌再灌注，改善其心功能，减少慢血流及无复流的发生率，且不增加主要不良心血管事件的发生率。 |
| 英文摘要: |
| Abstract Objective: To investigate the application of intravenous eptifibatide combined with percutaneous coronary intervention (PCI) target administration in acute ST-elevation myocardial infarction (STEMI) and its efficacy in patients with no-reflow or with slow blood flow. Methods: Eighty-one patients with acute STEMI and high thrombotic burden who underwent emergency interventional surgery were selected as investigators. According to the random number table method, they were divided into a study group (41 cases) and a control group (40 cases). The study group was given eptibatide target administration in the coronary artery during PCI, and intravenous maintenance infusion was continued for 24h after surgery. The control group was administered intravenously at the beginning of PCI until eptibatide was continuously intravenously instilled for a total of 24h after surgery. The myocardial perfusion indexes, cardiac function indexes, bleeding during hospitalization, no reflow, slow blood flow and major adverse cardiac events (MACEs) were compared between the two groups. Results: The postoperative ECG STR decreased in both groups, and the degree of decline in the study group was more obvious (P< 0.05). Serum levels of creatine kinase isoenzyme and troponin I were significantly decreased in the two groups (P< 0.05). For cardiac function indexes, the left ventricular ejection fraction and the left ventricular end-diastolic diameter decreased in both groups at 3rd month after operation, and the study group had a more significant improvement in cardiac function indexes than the control group (P< 0.05). The N-terminal B-type natriuretic peptide precursor was significantly lower in the study group after three months of surgery (P< 0.05). No reflow and slow blood flow occurred in both groups, no bleeding occurred in both groups (P> 0.05). The total incidence of no reflow and slow blood flow was lower in the study group (P< 0.05), and the total incidence of MACEs in the study group was lower (P< 0.05). Conclusion: The application of intravenous administration of eptibatide combined with targeted PCI in patients with acute STEMI can increase myocardial reperfusion and improve cardiac function, reduce the incidence of slow blood flow and no reflow, and does not increase the incidence of MACEs. |
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