Objective To determine the safety , efficacy and feasibility of Rapamycin drug-eluting stent ( Nanoplus Stent) combined with Tirofiban in the emergency percutaneous coronary intervention of acute myocardial infarction (AMI).Methods From September 2009 to August 2011 , 31 patients with AMI were treated with Nanoplus stents combined with Tirofiban. All patients were given 300 mg Aspirin and 300 mg Clopidogrel orally before and intravenous 8000-10000 U Heparin during coronary artery stenting. After balloon valvuloplasty , 10-15 mL of Tirofiban were injected into the coronary arteries followed by 0.15 g/kg min intravenous injection of Tirofiban for 24-48 h, and hypodermic injection of LMWH for 5 -7days after the procedure. Results 42 Nanoplus stents were successfully implanted in 3lcoronary arteries of 31 rnpatients. Apart from slow-reflow (1 patient) and hematoma (3) . no senous complications including acute or sub-acute thrombosis, recurrent myocardial infarction. emergency CABG or death from cardiac causes occurred in the early in hospital follow-up. At three to six months, there were no major adverse cardiac events. Six months after the procedure,there was no in-stent restenosis in 16 patients, who underwent coronary angiography. Conclusion Rapamycin-eluting stent (Nanoplus Stent) combined with Tirofiban is safe with favorable short and medium-term effect in the emergency intervention of acute myocardial infarction.%目的 评价国产药物洗脱支架(乐普支架)联合替罗非班在急性心肌梗死急诊介入治疗中的安全性、有效性及近中期疗效.方法 2009年9月～2011年8月,共62例急性心肌梗死患者行急诊介入治疗,随机分为替罗非班组和对照组,替罗非班组在对病变血管经皮冠状动脉介入治疗(PCI)过程中置入乐普支架.所有患者术前均口服负荷量阿司匹林300 mg、氯吡格雷300 mg.术中推注肝素8000～10 000 U.球囊预扩张病变血管后,冠脉内注射10～15 ml替罗非班,PCI术后0.15 g/(kg·min)静脉滴注维持24～48 h,术后皮下注射低分子肝素5～7d,对照组患者未冠脉内注射替罗非班.结果 两组患者一般资料比较,差异无统计学意义(P＞0.05).两组患者的梗死相关动脉PCI术后全部即刻再通,且梗死相关动脉即刻再灌注率,两者差异无统计学意义(P＞0.05).PCI术后替罗非班组梗死相关血管TIMI 3级血流获得率96.7％,高于对照组83.9％,差异有统计学意义(P＜0.05),校正TIM I计桢数显示替罗非班组血流速度高于对照组,差异有统计学意义(P＜0.05).所有患者住院期间均未发生急性、亚急性血栓,均未发生心源性死亡、再发急性心肌梗死、急诊CABG和重复PCI等主要不良心脏事件.所有患者均接受了临床随访,均无不良心血管事件:再发心绞痛、心肌梗死、心力衰竭及猝死等发生.其中,32例患者术后6个月复查了冠状动脉造影,无一例发生支架内再狭窄.结论 国产药物洗脱支架(乐普支架)联合替罗非班治疗用于急性心肌梗死急诊介入治疗,是安全、有效的方法,近中期效果良好.
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