替罗非班冠状动脉给药对冠心病合并SAS患者PCI术后慢血流现象及不良心血管事件发生的影响  

Effect of coronary artery administration of tirofiban on slow blood flow and adverse cardiovascular events in patients with coronary heart disease complicated with SAS after PCI

作　　者：王冠达 刘华长 张凯 WANG Guan-da;LIU Hua-chang;ZHANG Kai(Department of Cardiology II,the People's Hospital of Langfang City,Langfang 065000,Hebei,China)

机构地区：[1]廊坊市人民医院心内二科,河北廊坊065000

出　　处：《川北医学院学报》2024年第8期1102-1105,共4页Journal of North Sichuan Medical College

基　　金：河北省廊坊市科技计划项目(2018013149)。

摘　　要：目的:探讨替罗非班冠状动脉给药对冠心病合并睡眠呼吸暂停综合征(SAS)患者经皮冠状动脉介入治疗(PCI)术后慢血流现象及不良心血管事件(MACE)发生的影响。方法:按照治疗方式不同将120例冠心病合并SAS患者分为对照组(n=60)和观察组(n=60),两组患者均进行PCI治疗,对照组、观察组分别予以替罗非班静脉与冠状动脉给药。对比两组患者TIMI分级、血清心肌功能指标[乳酸脱氢酶(LDH)、谷草转氨酶(AST)、肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)]水平、PCI术后慢血流现象、血小板微粒(PMPs)水平、出血情况及MACE发生情况。结果:观察组术后即刻心肌梗死溶栓治疗(TIMI)分级优于对照组(P<0.05)。给药后,观察组cTFC低于对照组(P<0.05)。术后3 d,观察组PMPs水平低于对照组(P<0.05);血清LDH、AST、CK-MB、cTnI水平均低于对照组(P<0.05);两组出血情况无统计学差异(P>0.05)。观察组术后MACE总发生率低于对照组(P<0.05)。结论:替罗非班冠状动脉给药可以更好地预防冠心病合并SAS患者PCI术后慢血流现象发生,降低MACE发生率。Objective:To investigate the effect of coronary artery administration of tirofiban on postoperative slow blood flow and adverse cardiovascular events(MACE)in patients with coronary heart disease complicated with sleep apnea syndrome(SAS)undergoing percutaneous coronary intervention(PCI).Methods:According to different treatment methods,120 patients with coronary heart disease combined with SAS were divided into control group(n=60)and observation group(n=60).Both groups of patients underwent PCI treatment,with the control group receiving intravenous administration of tirofiban and the observation group receiving coronary administration of tirofiban.The serum myocardial function indicators[lactate dehydrogenase(LDH),aspartate aminotransferase(AST),creatine kinase isoenzyme(CK-MB),cardiac troponin I(cTnI)],slow blood flow phenomenon after PCI,platelet microparticle(PMPs)levels,bleeding,and occurrence of MACE were compared between the two groups of patients.Results:The observation group had better immediate thrombolytic therapy for myocardial infarction(TIMI)grading after surgery compared to the control group(P<0.05).After administration,the cTFC of the observation group was lower than that of the control group(P<0.05).3 days after surgery,the levels of PMPs in the observation group were lower than those in the control group(P<0.05),the serum levels of LDH,AST,CK-MB,and cTnI in the observation group were lower than those in the control group(P<0.05).There was no significant difference in bleeding between the two groups(P>0.05).The total incidence of postoperative MACE in the observation group was lower than that in the control group(P<0.05).Conclusion:Coronary administration of tirofiban can better prevent the occurrence of slow blood flow after PCI in patients with coronary heart disease complicated with SAS,and reduce the incidence of MACE.

关 键 词：冠心病 睡眠呼吸暂停综合征 替罗非班 冠状动脉给药 慢血流现象 不良心血管事件 

分 类 号：R541.4[医药卫生—心血管疾病]