早期应用盐酸替罗非班对非ST段抬高型急性冠状动脉综合征患者介入术后高敏C-反应蛋白水平的影响

Effect of early use of tirofiban hydrochlotide on serum high sensitivity C-reactive protein level in patients with non-ST-elevation acute coronary syndrome undergoing percutaneous coronary intervention

目的观察非ST段抬高型急性冠状动脉综合征(non-ST-elevation acute coronary syndromes,NSTE-ACS)患者应用盐酸替罗非班后血清高敏C-反应蛋白(high sensitivity C-reactive protein,hs-CRP)水平的变化,探讨盐酸替罗非班对NSTE-ACS可能的炎症抑制机制。方法 69例初诊为NSTE-ACS患者随机分为早期组35例(术前6～12h应用盐酸替罗非班)和术中组(介入术开始时应用盐酸替罗非班)34例,术前及术后24h检测hs-CRP水平及术后心肌灌注分级。结果术前早期组hs-CRP水平(9.21±1.12)mg/L与术中组(9.16±1.17)mg/L比较差异无统计学意义(P>0.05);术后早期组hs-CRP水平(4.29±2.23)mg/L较术中组(5.47±2.60)mg/L降低(P<0.05);术后早期组心肌灌注获得TMPG 2～3级比率77.1%明显高于术中组58.8%(P<0.05)。结论早期应用盐酸替罗非班可明显抑制炎性反应,延缓NSTE-ACS进程。

Objective To observe the effect of tirofiban hydrochlotide on serum high sensitivity C-reactive protein （hs- CRP） level in patients with non-ST-elevation acute coronary syndrome （NSTE-ACS） undergoing percutaneous coronary intervention （PCI） and to explore the inhibiting inflammation mechanism on acute coronary syndrome. Methods Sixty- nine patients with NSTE-ACS were randomly divided into preoperation group （n= 35） and intraoperation group（n = 34）. Tirofiban hydrochioride was used for 6 to 12 hours before operation in preoperation group and at the beginning of PCI in intraoperation group. Serum hs-CRP level and TMPG were recorded before and 24 hours after operation. Results There was no significant difference in hs-CRP level between preoperation group （（9.21± 1.12） mg/ID and intraoperation group （（9.16±1.17） mg/L） before operation （P〉0.05）. The hs-CRP level was lower in preoperation group （（4.29±2.23） mg/L） than that in intraoperation group （（5. 47±2. 60）mg/L） （P〈0.05）. The proportion of getting TMPG 2 and 3 was significant higher in preoperation group （77. 1%） than that in intraoperation group （58. 8%） （P〈0. 05）. Conclusion Early use of tirofiban hydrochloride can significantly delay the process of ACS through inhibiting inflammation.