经皮冠状动脉介入治疗术后应用替罗非班对阿司匹林抵抗患者心肌坏死标志物的影响  

Observation of tirofiban＇s effect on myocardial necrosis biomarker in patients with aspirin resistance following percutaneous coronary interventions

作　　者：李月平[1] 周玉杰[1] 张妍[1] 赵迎新[1] 刘宇扬[1] 袁慧[2] 董磊[3] 

机构地区：[1]首都医科大学附属北京安贞医院心血管12病区,北京100029 [2]首都医科大学附属北京安贞医院检验科,北京100029 [3]首都医科大学附属北京安贞医院血脂标化室,北京100029

出　　处：《中国综合临床》2008年第5期443-446,共4页Clinical Medicine of China

摘　　要：目的研究非急诊经皮冠状动脉介入治疗术（PCI）后应用替罗非班对阿司匹林抵抗患者心肌坏死标志物的影响。方法对口服阿司匹林100mg／d／〉7d（未服用其他抗血小板药物）拟行PCI的患者测定基础状态下的血小板聚集率、心肌坏死标志物[肌酸肌酶同工酶（CK—MB）和肌钙蛋白（TnI）]。PCI术前至少12h口服氯吡格雷300mg负荷量，以后服用75mg的维持量。成功PCI后随机分为常规治疗组和替罗非班治疗组，术后8、12、24h测定血清CK—MB和TnI，以CK-MB和TnI升高超过正常值为增高。结果符合入选条件的374例患者中83例存在阿司匹林抵抗（AR），占全部患者的22．2％，女性占54．2％；其中，常规治疗组45例，替罗非班组38例。替罗非班组患者CK．MB升高15例（39．5％），常规治疗组19例（42．2％），两组比较差异无统计学意义（P=0．8）；替罗非班组TnI增高18例（47．4％），常规治疗组23例（51．1％），两组比较差异无统计学意义（P=0．73）。PCI后不同时间CK—MB和TnI的水平以及和基线水平相比的增高程度没有统计学差异。结论替罗非班不能减少阿司匹林抵抗患者术后心肌坏死标志物的增高程度。Objective To investigate the effect of tirofiban on myocardial necrosis biomarker after percutaneous coronary interventions （ PCI ） in patients with aspirin resistance （ AR ） . Methods 374 consecutive patients with aspirin 100 mg≥1 week, receiving no other antiplatelet therapy , scheduled for PCI were enrolled, all patients were given an loading close of 300 mg clopidogrel at least 12 hours before PCI and an 75 mg maintenance close per day. Patients were randomized into tirofiban group （n = 38） and control group （n = 45） after PCI. The levels of CK- MB,TnI at 8,12,and 24 hours after PCI were measured in all patients;if the CK-MB,TnI value was above normal upper limitation,it was considered elevated. Results 83 patients were AR（ 22.2% ） and 54.2% of them are females. The frequencies of CK-MB elevation were 15 （ 39.5% ） in tirofiban group and 19 （ 42.2% ） in control group, and TnI elevation was 18 （47.4%） and 23 （51.1% ）in the two groups respectively. Conclusion Tirofiban can not decrease the elevation level of CK-MB and TnI in patients with AR after PCI.

关 键 词：经皮冠状动脉介入术 阿司匹林抵抗 替罗非班 肌酸肌酶同工酶 

分 类 号：R543[医药卫生—心血管疾病]