盐酸替罗非班对急性STEMI患者内皮功能的影响  

Effect of tirofiban hydrochloride on endothelial function in patients with acute ST segment elevation myocardial infarction

作　　者：龙盼[1] 张田田[1] 谢倩倩[1] 王瑾[1] 周军[1] 张俊峰[1] 

机构地区：[1]上海交通大学医学院附属第三人民医院心内科,上海201999

出　　处：《心脏杂志》2015年第5期553-555,564,共4页Chinese Heart Journal

基　　金：上海申康市级医院技术推广项目资助(SHDC12012210);上海市宝山区科委项目资助(12-E-63)

摘　　要：目的探讨血小板糖蛋白Ⅱb/Ⅲa受体拮抗剂(glycoproteinⅡb/Ⅲa inhibitor,GPI)盐酸替罗非班对急性ST段抬高型心肌梗死(ST segment elevation myocardial infarction,STEMI)患者内皮功能的影响。方法根据术前是否使用盐酸替罗非班,将100例于我院行急诊经皮冠状动脉介入(percutaneous transluminal coronary interventions,PCI)术的STEMI患者分为试药组(73例)和对照组(27例)。应用流式微球技术检测各组手术前后血浆内皮微粒(endothelial microparticles,EMP)表达变化;应用酶联免疫吸附试验(ELISA)检测血清细胞间黏附分子(intercellular adhesion molecule,ICAM)-1、内皮素(endothelin,ET)-1表达变化。结果术前试药组EMP、ICAM-1、ET-1表达与对照组相比无统计学差异;与术前相比,试药组术后EMP、ICAM-1、ET-1表达无明显变化,对照组术后EMP、ICAM-1、ET-1表达升高。结论盐酸替罗非班可抑制STEMI患者PCI术后EMP、ICAM-1、ET-1的上升,可能与改善内皮功能有关。AIM This study aimed to investigate the influence of platelet glycoprotein lib/Ilia inhibitor （GPI） tirofiban hydrochloride on endothelial function of ST segment elevation myocardial infarction （STEMI） patients. METHODS 100 STEMI patients who underwent emergency PCI in our hospitial were divided into the experimental drug group （n = 73 ） and control group （n = 27 ） according to whether tirofiban hydrochloride was used before PCI. Endothelial microparticle （EMP） expression was determined with cytometric bead array, whereas intercellular cell adhesion molecule-1 （ICAM-1） and endothelin-1 （ ET-1 ） with ELISA before and after PCI in both groups. RESULTS 1 ） There was no significant differ- ence of EMP, ICAM-1 and ET-1 levels in the drug experimental group and the control group before PCI. 2） There was no statistically significant difference of EMP, ICAM-1 and ET-1 levels in the drug experi- mental group before and after PCI. EMP level after PCI in the control group was higher than that before PCI, with statistical difference （P 〈0.05）. ICAM-1 and ET-1 levels after PCI in the control group were significantly higher than those before PCI （ P 〈 0. 01 ）. CONCLUSION Tirofiban hydroehloride was able to inhibit the increase of EMP, ICAM-1 and ET-1 in the serum of STEMI patients after PCI, which was related to improvement of endothelial function.

关 键 词：心肌梗死 ST段抬高型 血小板糖蛋白Ⅱb/Ⅲa受体拮抗剂 盐酸替罗非班 内皮微粒 经皮冠状动脉介入术 

分 类 号：R541.4[医药卫生—心血管疾病]