替罗非班对糖尿病并ST段抬高急性心肌梗死PC I术后支架再狭窄的影响

Effects of tirofiban on in-stent restenosis in patients with acute ST-elevation myocardial infarction accompanied with diabetes mellitus undergoing urgent percutaneous coronary interventions

目的探讨急诊经皮冠状动脉介入治疗(PCI)术应用国产替罗非班对糖尿病ST段抬高急性心肌梗死(AMI)病人支架植入术后再狭窄的影响。方法104例首发ST段抬高AMI且有糖尿病并接受急诊PCI治疗的病人,随机分为替罗非班组(n=51)和常规治疗组(n=53),替罗非班组病人诊断后即刻给予替罗非班氯化钠注射液10μg·kg^(-1)于3 min内推注完毕,术后替罗非班0.15μg·kg^(-1)·min^(-1)滴注24～36h,其余治疗同常规治疗组。均于术后6mo复查冠状动脉造影,了解支架内再狭窄的发生情况。结果与常规治疗组比较,替罗非班组术后6 mo支架再狭窄发生率减少(18%vs 10%),差异有显著意义(P<0.05)。结论替罗非班可降低糖尿病并ST段抬高急性心肌梗死病人急诊经皮冠状动脉介入治疗术后支架再狭窄的发生。

AIM To evaluate the effects of tirofiban on in-stent restenosis in patients with acute ST- elevation myocardial infarction （STEMI） accompanied with diabetes mellitus undergoing urgent percutaneous coronary interventions （PCI）. METHODS One hundred and four patients with acute STEMI accompanied with diabetes mellitus admitted in our hospital were randomized into two groups. Fifty-three patients in control group were treated with conventional treatment, and 51 patients in tirofiban group were administered with tirofiban （10 μg·kg-1, iv bolus） within 3 minutes after the diagnosis and tirofiban （0.15 μg·kg-1.min-1 intravenous drip） for 24 - 36 h after PCI on the basis of conventional treatment. The incidence of in-stent restenosis was assessed by coronary angiography at 6 months after urgent PCI. RESULTS The incidence of in-stent restenosis was lower in tirofiban group than that in control group at 6 months after urgent PCI （P 〈 0.05）. CONCLUSION The application of tirofiban could prevent in-stent restenosis in patients with acute STEMI accompanied with diabetes mellitus undergoing urgent PCI.