替罗非班用药时机对不同类型心肌梗死患者PCI疗效的影响  

Effect of Tirofiban Timing on PCI Therapeutic Effect in Patients with Different Types of Myocardial Infarction

作　　者：郭晓平 陈维[1] 刘倩倩[1] 孙笑眉 兰冰[1] 王佟[1] 韩文忠[1] GUO Xiaoping;CHEN Wei;LIU Qianqian;SUN Xiaomei;LAN Bing;WANG Tong;HAN Wenzhong(Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Cangzhou,Hebei,China 061001)

机构地区：[1]河北省沧州中西医结合医院,河北沧州061001

出　　处：《中国药业》2020年第8期121-123,共3页China Pharmaceuticals

基　　金：河北省沧州市重点研发计划指导项目[183302082]。

摘　　要：目的探讨不同时机应用替罗非班对ST段抬高型心肌梗死(STEMI)和非ST段抬高型心肌梗死(NSTEMI)经皮冠状动脉介入(PCI)疗效的影响。方法选取医院2017年1月至2018年6月收治的STEMI和NSTEMI并行PCI术患者300例,随机分为术前用药组(术前早期给予替罗非班)和术后用药组(术后即刻给予替罗非班)。结果STEMI及NSTEMI术前用药组患者术前的TIMI血流分级明显高于术后用药组,且STEMI术前用药组患者术后的TIMI血流分级明显高于术后用药组(P<0.05);STEMI及NSTEMI术前用药组患者PCI术后1 h内的ST段回落值均明显高于术后用药组(P<0.05);STEMI及NSTEMI术前用药组与术后用药组患者出院前左心室收缩与舒张功能,PCI术后不良反应发生率,以及与术后随访1个月内、半年内和1年内主要不良心血管事件的发生率均无明显差异(P>0.05)。结论对于STEMI和NSTEMI患者,PCI术前应用替罗非班较PCI术后应用,更能显著增强心肌血流灌注与改善心肌细胞微循环,且术前与术后用药的安全性无明显差异。Objective To investigate the efficacy of tirofiban at different time on percutaneous transluminal coronary intervention(PCI)treatment of ST-segment elevation myocardial infarction(STEMI)and non-ST-segment elevation myocardial infarction(NSTRMI).Methods A total of 300 patients with STEMI and NSTRMI admitted to the hospital from January 2017 to June 2018 were selected and randomly divided into two groups:the preoperative medication group(tirofiban was used early before operation)and the postoperative medication group(tirofiban was used immediately after operation).PCI was given to both groups.Results TIMI blood flow gradings before and after PCI were significantly higher in the preoperative medication group than in the post-operative medication group(P<0.05);ST segment fall values in the preoperative medication group were higher than those in the post-operative medication group within 1 h after PCI(P<0.05).There was no significant difference in left ventricular systolic and diastolic function,adverse reactions after PCI and the incidence of MACE in 1 month,6 months and 1 year of follow-up between the two groups(P>0.05).Conclusion Tirofiban can significantly increase myocardial perfusion and improve microcirculation of myocardial cells in patients with STEMI and NSTRMI before and after PCI.There is no significant difference in the safety of tirofiban before and after PCI.

关 键 词：替罗非班 ST段抬高型心肌梗死 非ST段抬高型心肌梗死 用药时机 经皮冠状动脉介入治疗 

分 类 号：R969.4[医药卫生—药理学] R972[医药卫生—药学]