Rho激酶抑制剂在急性冠脉综合征介入治疗中的应用价值  

Application value of Rho-kinase inhibitor in acute coronary syndrome patients with percutaneous coronary intervention

作　　者：李文华[1] 何国平[1] 李勇[1] 

机构地区：[1]江苏省常州市武进人民医院心内科,江苏常州213000

出　　处：《实用临床医药杂志》2016年第19期12-15,共4页Journal of Clinical Medicine in Practice

基　　金：江苏省常州市武进区科技发展(社会发展)(WS201320)

摘　　要：目的应用SYNTAX评分,观察Rho激酶抑制剂法舒地尔对不同评分组的急性冠脉综合征患者介入术后左心功能、一年支架内再狭窄（ISR）和主要心脏不良事件（MACE）的影响。方法入选急性冠脉综合征患者238例,均经冠脉造影证实存在单支以上的病变,均拒绝行冠脉搭桥手术,按随机数字表法分为治疗组（法舒地尔,n=102）和对照组（n=136）,根据SYNTAX评分,每组再分为评分低值亚组（0~22分）、评分值中等亚组（23~32分）和评分值高亚组（≥33分）,正规冠心病二级预防治疗,并行冠脉造影和支架植入治疗,随访一年,对比观察2组以及2组的亚组间在术中慢血流或无复流、急性或亚急性支架血栓、左心功能、一年内支架内再狭窄率和MACE事件的差异。结果治疗组和对照组观察的各项指标无显著差异（P〉0.05）,2组对应的评分低值组亚组间以及评分中等值亚组间观察的各项指标无显著差异（P〉0.05）;与对照组的评分高值亚组相比,治疗组的评分高值亚组术中发生慢血流或无复流的比例、1年支架内再狭窄比例和MACE事件的发生率显著降低（P〈0.05）,3个月的左心功能明显改善（P〈0.05）。结论 Rho激酶抑制剂可显著减少SYNTAX评分高值（≥33分）的ACS患者介入术中慢血流或无复流的发生,改善左心功能,并降低1年内支架内再狭窄率和MACE事件的发生率。Objective To explore the clinical effects of Rho-kinase inhibitor on left heart function,in-stent restenosis（ ISR） and major adverse cardiac events（ MACE） of patients with ACS in PCI by adopting Syntax score. Methods A total of 238 ACS patients with coronary angiography（ CAG） and PCI were randomly divided into treatment group（ fasudil,n = 102） and control group（ n = 136）. According to syntax score,each group was divided into low-score group,middle-score group and high-score group. The effective measures of the secondary prevention of coronary artery disease were taken in a year. The differences were analyzed with SPSS,including coronary slow flow or non-reflow phenomenon,ISR and MACE between the two groups and sub-groups. Results There were no significant differences between the two groups in clinical indexes. Compared with the highscore contrast sub- group,the rate of coronary slow flow or non-reflow,ISR and MACE in the highscore treatment group were significantly lower. Left heart function improved significantly in high-score treatment sub-group（ P〈0. 05）. Conclusion Rho-kinase inhibitor can reduce the rate of coronary slow flow or non-reflow,ISR and MACE in patients with ACS in high-score group,and improve the left heart function.

关 键 词：RHO激酶抑制剂 瑞舒伐他汀 急性冠脉综合征 SYNTAX评分 支架内再狭窄 支架内血栓 

分 类 号：R541[医药卫生—心血管疾病]