替罗非班在冠脉支架植入术后急性血栓形成中的应用

Application of tirofiban in acute thrombosis after successful stent implantation in patients with coronary artery disease

目的:观察替罗非班在支架植入术后冠脉内非支架植入部位急性血栓形成中的应用。方法:27例成功行冠脉内支架植入术术后非支架植入部位血栓形成的患者给予替罗非班应用(G1,n=27),18例成功行冠脉内支架植入术术后非支架植入部位血栓形成后给予血栓形成部位支架植入患者作为对照组(G2,n=18)。术后所有患者在给予常规低分子肝素抗凝、拜阿司匹林、波立维抗血小板治疗基础上监测CK-MB及cTn-I及有无出血并发症,所有患者于术后1周内复查冠脉造影(CAG)。结果:①除G1组1例因靶血管内反复弥漫性血栓形成死亡外,G1组和G2组复查CAG均未见有血栓形成。②G1组1例患者出现上消化道出血并发症经对症处理后出血停止,余患者无并发症出现,G1组和G2组各有1例患者术后CK-MB及cTn-I升高。结论:替罗非班在PC I术后冠脉内非支架植入部位急性血栓形成中的应用同血栓形成部位支架植入一样安全有效,且更为经济。

Objective： To observe the application of tirofiban in acute thrombosis in non-stent-location after successful stent implantation. Methods ： Tirofiban was prescribed in 27 patients with acute thrombosis in non-stent-location undergoing successful stent implantation （ G1 , n = 27 ） , 18 patients serve as control group （G2, n = 18 ） were given stent implanted in the location of acute thrombosis after successful stent implantation. Except the routine usage of low molecular heparin, aspirin and clopidogrel, CK-MB and cTn-I were detected to find the new occurrence of infarction, clinical manifestation was closed attention to the cue of complication. All patients were given a second CAG in seven days after the stent implantation. Results： ①Except one case dead of diffuse thrombus formation in G1 group, there is no case with thrombosis both in G1 and G2 groups. ② one case in group Gl manifested the complication of upper gastrointestinal hemorrhage, and the bleeding stopped after proper treatment, the others showed no complication. There is one case both in G1 and G2 groups show a cardiac biomarker （CK-MB and cTn-I included） rised. Conclusion： The application of tirofiban in acute thrombosis in non-stent-location after successful stent implantation has the same effectivity and safety compared with stent implantation at the location of thrombus formation and the former is more economic.