替罗非班在非ST段抬高急性冠脉综合征介入治疗前后的研究

Clinical Study of Pre-angiographic Use of Tirofiban in PCI for Non-ST Elevation Acute Coronary Syndrome

目的探讨盐酸替罗非班对非ST段抬高急性冠脉综合征(NSTE-ACS)患者经皮冠状动脉介入治疗(PCI)的临床疗效和安全性。方法将2009-07～2011-04间,植入药物洗脱支架(DES)NSTE-ACS患者随机分为替罗非班试验组(n=38)和对照组(n=36)。比较PCI前后病变血管血流TIMI分级、出血事件和血小板减少以及1个月内的不良心血管事件的发生率。结果试验组和对照组的一般临床情况、冠状动脉造影及介入治疗基线特征均无统计学差异。应用替罗非班后的试验组PCI术前病变血管血流达到TI-MI 3级的比率显著高于对照组(71.1%VS 44.4%,P<0.05);术后试验组血流达到TIMI 3级的比率较对照组高(94.7%VS 88.9%,P>0.05),但无统计学差异。出血事件和血小板减少以及1个月内的不良心血管事件的发生率差异,无统计学意义(P>0.05)。结论替罗非班在非ST段抬高急性冠脉综合征介入治疗中是安全有效的,能够提高PCI术前病变血管血流,不增加出血并发症。

Objective To investigate the effect and safety of tirofiban in PCI patients with non-ST elevation acute coronary syndrome（NSTE-ACS）.Methods From July 2009 to April 2011,74 high-risk patients with NSTE-ACS underwent drug-eluding stent（DES） implantation were divided into tirofiban group（n=38）and control group（n=36）randomly.Basic clinical characteristics,TIMI flow before and after PCI,incidences of bleeding and thrombocytopenia in the hospital,and the incidences of major cardiovascular events at 1 month were compared between two groups.Results The baseline clinical and angiographic characteristics,PCI procedures and immediate between the two groups had no significant difference.The percentage of TIMI 3 flow achieved in tirofiban group before PCI was higher than that in control group（71.1% VS 44.4%,P0.05）,but there were no significant difference in percentage of TIMI 3 flow achieved after PCI between the two groups.There were no significant differences in occurrence of bleeding complication and major cardiovascular events in both groups（P0.05）.Conclusion It is safe and effective for pre-angiographic use of tirofiban in PCI patients with NSTE-ACS.Tirofiban might increase blood flow before PCI,improve myocardial perfusion,and can not add bleeding complication.