盐酸替罗非班对急性冠脉综合征患者经皮冠状动脉介入治疗后心功能和安全性的影响  

Observation on the effect and safety of applying tirofiban hydrochloride in patients with acute coronary syndrome after percutaneous coronary intervention

作　　者：崔英俊[1] 季淑艳[1] 

机构地区：[1]武警天津总队医院内科,天津300162

出　　处：《武警后勤学院学报（医学版）》2014年第7期570-573,595,共5页Journal of Logistics University of PAP（Medical Sciences）

摘　　要：【目的】探讨盐酸替罗非班对急性冠状动脉综合征患者经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后疗效和安全性的影响。【方法】196例行PCI的ACS患者随机分成2组,治疗组(PCI+盐酸替罗非班)于术前给予常规量低分子肝素,术后在半量低分子肝素基础上给予盐酸替罗非班0.1μg·(kg·min)-1微量泵持续泵入共24 h;对照组(PCI+低分子肝素)术前、术后只给予常规量低分子肝素。观察两组患者用药后TIMI血流分级、心功能、肌酸激酶同工酶(creatine kinase isoenzyme MB,CK-MB)和肌钙蛋白I(troponin I,cTNI)峰值和达峰时间、术后中性粒细胞计数、血小板聚集率及出血情况,同时记录住院期间及随访6个月的主要不良心血管事件的发生情况。【结果】治疗组术后即刻TIMI3级血流灌注、左室射血分数较对照组显著升高(P<0.05);治疗组CK-MB、cTNI达峰值低于对照组(P<0.05),达峰时间早于对照组(P<0.05);两组中性粒细胞计数、血小板聚集率手术后均有明显降低,治疗组更为明显(P<0.05);两组手术后出血情况、不良心血管事件发生数没有统计学差异(P>0.05)。【结论】急性冠脉综合征患者在进行PCI时加入盐酸替罗非班可改善冠脉血流灌注,减少心肌损害。[Objective]To study the postoperative effect and safety of applying tirofiban hydrochloride in patients with acute coronary syndrome （ACS） after percutaneous coronary intervention （PCI） operation. [Methods] A total of 196 routine PCI patients with ACS were randomly divided into two groups. Treatment group （PCI＋tirofiban hydrochloride）： regular amount of low molecular heparin before PCI operation,and 0.1 μ g （kg min）-1 trace pump of tirofiban hydrochloride for pumping a total of 24 h was given after PCI based on the half the amount of low molecular heparin. Control group： conventional low molecular heparin before and after PCI operation. To observe TIMI flow grade,cardiac function, creatine kinase isoenzyme MB （CK-MB） and troponin I （cTNI） peak and tmax, postoperative neutrophil count, platelet aggregation rate and postoperative bleeding were recorded in both groups. At the same time major adverse cardiac events （MACE） in hospital and in the following 6 months were also recorded. [ Results ] The immediate postoperative TIMI 3 perfusion level, left ventricular ejection fraction（LVEF） in treatment group were significantly higher than that of control group （P 〈 0.05）. The CK-MB and cTNI peak value were lower than the control group （P 〈 0.05）, peak time was earlier than that of the control group （P 〈 0.05）. Neutrophil count,platelet aggregation rate in two groups significantly decreased as compared with that before and after operation, while the treatment group it was more obvious than the control group （P 〈 0.05）. There was no statistical difference in the comparison of bleeding,adverse cardiovascular events （MACE） in two groups. [ Conclusions ] When acute coronary syndrome patients undergoing PCI operation the addition of tirofiban hydrochloride can improve coronary perfusion and ruduce myocardial damage.

关 键 词：血小板糖蛋白Ⅱb Ⅲa受体拮抗剂 盐酸替罗非班 急性冠脉综合征 

分 类 号：R541.4[医药卫生—心血管疾病]