替罗非班对急性冠脉综合征患者PCI术后心功能及炎症因子的影响

Influence of Tirofiban on inflammation factors and cardiac function in patients with acute coronary syndrome after PCI

目的观察替罗非班对急性冠状动脉综合征(ACS)患者经皮冠状动脉介入术(percutaneous coronary intervention,PCI)治疗后心功能及血清炎症因子的影响。方法初次确诊为ACS81例,对照组41例,不应用替罗非班;替罗非班组40例,利用替罗非班治疗,分别在术前、术后30 min、6 h测定血清可溶性CD40配体、高敏C反应蛋白、IL-6水平,并利用超声心动图测定所有患者术前、术后1月、术后3月的EF值以此评估患者的心功能。结果术后30min、6 h,对照组可溶性CD40配体、高敏C反应蛋白、IL-6水平均明显升高,较术前有统计学差异(P<0.05),替罗非班组指标显著低于术前,较术前有统计学差异(P<0.05);较对照组之间差异有统计学意义(P<0.05)。PCI术后1月、3月所有患者的EF值均有明显升高,较术前有统计学差异(P<0.05);替罗非班组心功能改善更明显,较对照组具有统计学差异(P<0.05)。结论 ACS患者PCI术后应用替罗非班可明显降低血清炎症因子的水平及改善患者的心功能。

[ Objective ] To observe the effect of tirofiban on both inflammatory factors and cardiac function in patients with ACS after PCI. [Methods] A total of 81ACS patients were enrolled in the trial. All patients were randomly divided into two groups： tirofiban group （n =40） and placebo group （n =41）. Serum soluble CD40, hsCRP and IL-6 were measured before PCI and 30 min, 6 h after the surgery. The cardiac function of post-surgery patients was evaluated by echoeardiography before PCI and lmonth, 3month after surgery. [Results] Serum soluble CD40, hsCRP and IL-6 significantly increased at 30 rain and 6 h after PCI in sham group （P 〈0.05）. Serum soluble CD40, hsCRP and IL-6 significantly decreased at 30 rain and 6 h after PCI in tirofiban group （P 〈0.05）. Significant difference also exists between tirofiban group and placebo group （P 〈0.05）. LVEF significantly elevated in both groups （P 〈0.05）. However, LVEF in tirofiban group were significantly higher than placebo group （P 〈0.05）. [ Conclusion ] Tirofiban could significandy decrease serum level of inflammatory factors and improve cardiac function in patients with ACS after PCI.