替罗非班对冠状动脉介入治疗中支架植入后慢血流的影响  

Effect of intracoronary tirofiban on slow blood flow after stent implantation

作　　者：王春梅[1] 朱小玲[1] 艾辉[1] 张倩[1] 李响[1] 刘子军[1] 

机构地区：[1]首都医科大学附属北京安贞医院抢救中心,100029

出　　处：《中国医药》2011年第6期648-649,共2页China Medicine

摘　　要：目的 观察冠状动脉内注射替罗非班在冠状动脉介入治疗（PCI）中支架植入后出现慢血流的影响。方法回顾性分析2008年1月至2011年1月于我院抢救中心因急性冠状动脉综合征行PCI过程中出现慢血流的患者201例，根据冠状动脉内应用硝酸甘油基础上是否联合应用替罗非班分为替罗非班组和对照组，观察2组患者用药后血流恢复情况。结果替罗非班组急性心肌梗死、术前心肌梗死溶栓试验（TIMI）血流0～1级及术后达到TIMI血流3级比例明显高于对照组[71例（76．3％）比66例（61．1％）、47例（50．5％）比39例（36．1％）、88例（94．6％）比92例（85．2％），P=0．046、0．023、0．037），而不稳定型心绞痛比例则明显低于对照组[22例（23．7％）比42例（78．9％），P=0．023]。虽轻度出血比例替罗非班组有高于对照组的趋势，但差异无统计学意义（P=0．085）。2组均无中、重度出血发生。结论冠状动脉内联合应用替罗非班与硝酸甘油能够安全有效地改善PCI后慢血流现象，提高手术成功率。Objective To investigate the effect of intracoronary tirofiban and nitroglycerol on slow blood flow after stent implantation during percutaneous coronary intervention （PCI）. Methods Totally 201 patients with acute coronary syndrome（ACS） undergoing PCI were enrolled in this study from January 2008 to January 2011. The patients were divided into 2 groups according to intracoronary tirofiban and nitroglycerol（ tirofiban group） or nitroglycerol only（control group）. Results Tirofiban group had significantly increased risk of the rate of acute myocardial infarction, TIMI flow 0-1 before PCI[71 cases（76.3% ） vs 66 cases（61.1% ）, 47 cases（50.5% ） vs 39 cases （36.1% ）, P = 0. 046,0. 023 ], but lower rate of unstable angina pectoris （UA） than control group [ 22 cases （23.7 % ） vs 42 cases （78.9%）, P = 0.023 ]. Tirofiban group had higher rate of TIMI flow 3 after PCI. Although the slight bleeding incidence in the control group was less than that in the tirofiban group, no severe bleeding was observed between 2 groups. Conclusion Intracoronary tirofiban and nitroglycerol can safely and effectively reduce the incidence of slow flow in patients after stent implantation during PCI.

关 键 词：血管成形术 经腔 经皮冠状动脉 替罗非班 硝酸甘油 慢血流 

分 类 号：R543.3[医药卫生—心血管疾病]