冠脉内注射替罗非班治疗急性冠脉综合征介入术中无复流的有效性和安全性

Efficacy and safety of intracoronary tirofiban on no-reflow patients after PCI in acute coronary syndrome

目的:评价冠脉内注射国产盐酸替罗非班对急性冠脉综合征(ACS)介入术(PCI)中无复流患者TIMI(心肌梗死溶栓治疗)血流的影响及安全性。方法:ACS患者行支架植入术中判定无复流者51例,随机分为替罗非班组(冠脉内注射盐酸替罗非班10μg/kg)27例,硝酸甘油组(冠脉内注射硝酸甘油200μg)24例。观察给药后30 min TIMI血流分级、2 d后安全性的终点及30 d主要不良心血管事件(MACE)发生率。结果:替罗非班组介入术中无复流患者30 min TIMIⅢ级血流获得率显著高于硝酸甘油组(67%∶29%,P<0.05);两组患者30 d的MACE发生率替罗非班组低于硝酸甘油组(0∶8%),但差别无统计学意义;替罗非班组出血不良反应较硝酸甘油组略高(11%∶8%),但差别亦无统计学意义;两组活化部分凝血活酶时间(APTT)、血红蛋白(Hb)、血小板(Plt)没有明显变化。结论:冠脉内注射国产盐酸替罗非班治疗ACS介入术中无复流患者是有效和安全的。

Objectives：To evaluate the efficacy and safety of intracoronary tirofiban on TIMI flow in acute coronary syndrome（ACS） with no-reflow after PCI.Methods：Fifty-one ACS patients with no-reflow after PCI were randomized to tirofiban group（intracoronary tirofiban,10 μg/kg,n=27） and nitroglyceride group（intracoronary nitroglyceride,200 μg,n=24）.Targets to be observed consisted of TIMI flow at 30 minute post-medication,safety end-points of 2-day post-PCI and incidence of major adverse cardiovascular events（MACE） of 30-day post-PCI.Results：The TIMI 3 ratio in tirofiban group was markedly higher than that in nitroglyceride group（67% vs 29%,P0.05）.No significant difference was found in the incidence of MACE of 30-day post-PCI and bleeding events between tirofiban and nitroglyceride groups（0% vs 8%;11% vs 8%）.No change was significantly observed in the two groups of activated partial thromboplastin enzyme time（APTT）,hemoglobin（Hb）,platelets（Plt）.Conclusions：The administration of intracoronary tirofiban is effective and safe for ACS patients with no-reflow after PCI.