替罗非班在急性冠脉综合征介入治疗中无复流的临床观察  

CLINICAL OBSERVATION OF INTRACORONARY TIROFIBAN ADMINISTRATION ON NO-REFLOW IN PATIENTS WITH ACUTE CORONARY SYNDROME DURING PERCUTANEOUS CORONARY INTERVENTION

作　　者：曾建辉[1] 吕湛[1] 曹宇[2] 

机构地区：[1]川北医学院附属医院心内科,四川南充637000 [2]中南大学湘雅三医院心内科

出　　处：《泸州医学院学报》2011年第4期387-389,共3页Journal of Luzhou Medical College

摘　　要：目的:评价冠状动脉内应用替罗非班对急性冠脉综合征(ACS)患者经皮冠状动脉介入治疗(PCI)中无复流的临床疗效。方法:将行PCI治疗中发生无复流的急性冠脉综合征(ACS)患者62例随机分为替罗非班组(n=32)和对照组(n=30)。两组手术方法相同,出现无复流现象后分别经冠状动脉内注入替罗非班和硝酸甘油。观察两组注射药物后首次和PCI中末次造影图像,评估心肌梗死溶栓试验(TIMI)血流分级、校正的TIMI帧数(CTFC),同时观察术后1周左室射血分数(LVEF)、术后60d内主要心血管事件(MACE)发生率及出血并发症等情况。结果:替罗非班组2次冠状动脉造影TIMI 3级血流获得率、CTFC均明显优于对照组(P<0.05),术后1周LVEF、出血并发症高于对照组,PCI术后60d内MACE发生率低于对照组,但差异无统计学意义(P>0.05)。结论:替罗非班在不增加严重出血并发症的前提下可明显降低和改善ACS患者PCI后无复流现象,是一种有效的PCI辅助治疗手段。Objective：To investigate the effect of intracoronary tirofiban administration on no-reflow phenomenon during primary percutaneous coronary intervention（PCI） in patients with acute coronary syndrome（ACS）.Methods： 62 patients with ACS undergoing PCI were randomly divided into tirofiban group（n=32） and control group（n=30）.The two groups were administered intracoronary bolus tirofiban and nitroglycerin during PCI respectively.All patients underwent one standard of PCI.Thrombolyses in myocardial infarction（TIMI）grade were observed immediately by angiography after the administration and before the end of PCI.Baseline characteristics,TIMI grade and corrected TIMI frame count（CTFC）of the two groups were compared.Left ventricular ejection fraction（LVEF） and incidence of major adverse cardiac event（MACE） and adverse drug effect in 60 days follow-up were also recorded.Results： Compared with control group,TIMI 3 grade flow and CTFC in tirofiban group increased significantly（P0.05）.Compared with the control group,the ejection fraction was higher and there was more bleeding complications in tirofiban group,but the differences were not significant（P0.05）.MACE in tirofiban group was lower than control group,but there was no significant difference between two groups（P0.05）.Conclusion： Intracoronary adminstration of tirofiban bolus during PCI to treat patients with ACS can prevent no-reflow phenomenon effectively.

关 键 词：急性冠脉综合征 替罗非班 经皮冠状动脉介入治疗 无复流 

分 类 号：R543.3[医药卫生—心血管疾病]