Objective To assess the effects and safety of glycoprotein Ⅱ b/Ⅲ a receptor inhibitors tirofiban( intracoronary administration and venous maintenance) combined with DIVERTM CE thrombus-aspiration catheter in the percutaneous coronary intervention (PCI)-treated patients with acute ST-segment elevation myocardial infarction (ST-EMI).Methods Sixty patients with ST-EMI who underwent PCI were randomized into two groups.Thirty-two patients in group A were treated with tirofiban,twenty-eight patients in group B were treated with tirofiban and thrombus-aspiration catheter.Between two groups,the thrombolysis in myocardial infarction (TIMI) risk score,hemorrhagic complications,and incidence of major adverse cardiovascular events (MACE) were compared.Results The TIMI flow was improved in both groups,and it was better in group B than group A ( P ＜ 0.05 ).The incidence of MACE in group B was lower than group A (25.0％ vs 3.6％,P ＜0.05). No fatal hemorrhagic complications were found in both groups.Conclusions Application of tirofiban and DIVERTM CE thrombus-aspiration catheter is safe and effective in ST-EMI patients,which can greatly improve myocardial reperfusion and reduce incidence of MACE.

【目的】评价急性ST段抬高性心肌梗死(STEMI)急诊经皮冠状动脉介入治疗(PCI)联合应用盐酸替罗非班治疗的临床疗效和安全性。【方法】选择急诊STEMI行急诊PCI有无复流或慢血流患者58例,分为实验组(冠脉内推注并静脉滴注盐酸替罗非班+常规治疗)32例,对照组(常规治疗)26例。比较TIMI血流情况、MACE。【结果】实验组TIMI血流恢复及TIMI3级明显较对照组高(87.5%比46.15%,56.25%比11.5%,P<0.05);MACE发生率实验组校对照组减低(5%比16.3%,P<0.05)。【结论】血小板GPⅡb/Ⅲa(替非罗班)受体拮抗剂冠脉内推注后持续静脉滴注维持,可改善TIMI血流,减少近期心血管事件。

目的 比较带侧孔指引导管与常规指引导管在左主干病变治疗中的副作用.方法 选起42例左主干病变患者,其年龄、部位、合并症等经统计学处理无差别,带侧孔指引导管组20例,常规指引导管组22例,观察其治疗过程并发症.结果 带侧孔组出现心绞痛3例、室性早搏(室早)6例、室性心动过速(室速)2例,常规组心绞痛12例、低血压10例、早搏11例、室速5A例、室颤1例、急性闭塞1例;并发症显著高于带侧孔组.结论 在左主干病变治疗中,尤为开口及中段,用带侧孔指引导管较常规指引导管好,可以减少并发症.

患者男,68岁.因高血压病10年,糖尿病5年,双下肢痛2年,于2006年11月28日17:30入院.查:BP180/110 mmHg,双肺清,心界向左下轻度扩大,心率84次/min,律齐,无杂音,双下肢无浮肿,无色素沉着、溃疡,双下肢膝关节以下压痛,尤以左下肢腓肠肌明显,深浅感觉正常.

【目的】探讨氨碘酮在老年人心律失常治疗中的维持量。【方法】氨碘酮0.2 g,每天三次,控制后逐渐减量至0.1 g隔日一次,每周用三次维持3个月至1年半,观察其心电图、甲状腺功能、肝肾功能、胸片、眼科检查。【结果】6例在起始阶段未控制,未进入继续用药;其余心律失常控制好,其中6例氨碘酮改为0.1g,每天一次,每周用5 d,2例FT4偏低,其余与服药前无变化,对肝、肾、肺均无明显影响。【结论】氨碘酮极小剂量维持,在老年人中应用是安全的。

【Objective】To investigate the effect of lipid,inflammation on long-term outcome of coronary heart disease(CHD).【Methods】This was case follow-up study,enrolled 398 cases with CHD between 2003 and 2006,and followed up for patients with coronary heart diseases.【Results】①After follow-up for patients with or without cardiovascular events,there was not significant difference between baseline lipid and inflammation markers.②In patients with CABG,not PCI,there were less angiopectoris and request for revascularization.【Conclusion】Baseline levels of lipid and inflammation markers do not predict long-term outcome of patients;CABG is inverse factor for predcting cardiac events.