早期使用替罗非班对非ST段抬高急性冠脉综合征患者冠脉介入术后C反应蛋白及心肌标志物的影响

Effect of Early Tirofiban on C-reactive Protein and Cardiac Markers in Patients with Non-ST-elevation Acute Coronary Syndromes after Percutaneous Coronary Intervention

目的观察早期使用替罗非班对非ST段抬高的急性冠脉综合征(NSTE-ACS)患者在冠脉介入治疗(PCI)术后C反应蛋白(CRP)、心肌标志物肌酸激酶同工酶(CKMB)、肌钙蛋白(TnI)及主要心血管不良事件(MACE)、出血事件的影响。方法将入选的择期行PCI的NSTE-ACS患者随机分为早期使用替罗非班组(n=24,PCI术前12～24h)和术中使用替罗非班组(n=23,PCI术开始时)。术前及术后24h查CRP、CKMB、TnI。观察PCI术后3d出血事件。随访30d,记录MACE。结果与术中替罗非班组比较,早期替罗非班组没有降低术后CRP水平,没有影响术后CKMB、TnI水平(均P>0.05),没有减少术后30dMACE,出血事件发生率亦无明显差异。结论对于择期行PCI的NSTE-ACS患者,与术中使用替罗非班比较,早期使用替罗非班没有更多获益。

Objective To observe the effect of early tirofiban on C-reactive protein（CRP） ,creatine kinase MB（CKMB） ,troponin I（TnI）, and major adverse cardiovascular events（MACE）in patients with non-ST-elevation acute coronary syndromes （NSTE-ACS） undergoing percutaneous coronary intervention（PCI）. Methods Patients with NSTE-ACS undergoing PCI were selected and randomized into early tirofiban group（n=24,12- 24 h before PCI） and late tirofiban group（n= 23, immediately before PCI）. CRP,CKMB, and TnI were measured at baseline and after PCI. The incidence of bleeding complications was observed in 3 days after PCI. The incidence of MACE was recorded during a follow-up period of 30 days after PCI. Results Compared with late tirofiban group,the levels of CRP were not decreased,the levels of CKMB and TnI had no significant change（all P〉 0.05） ,and the incidence of MACE was not reduced in early tirofiban group. The incidence of bleeding complications had no significant difference between two groups. Conclusion In patients with NSTE-ACS undergoing PCI, early use of tirofiban may have no more benefit.