替罗非班和磺达肝癸钠联用在急性冠脉综合征中的疗效

Effects of administration of tirofiban and fondaparinux in acute coronary syndrome patients

目的评估非ST段抬高急性冠脉综合征(NSTEACS)患者经皮冠状动脉介入(PCI)手术期联合应用替罗非班和磺达肝癸钠的效果。方法连续入选211例NSTEACS患者,随机分为实验组105例(围术期联合应用替罗非班和磺达肝癸钠),对照组106例(围术期单独应用磺达肝癸钠)。对比两组术后冠脉血流校正的心肌梗死溶栓(TIMI)帧数(CTFC)计数、心肌坏死标志物升高及术后6个月主要心脏不良事件(MACE)的发生率。结果与对照组比较,实验组患者PCI术后CTFC得到明显改善;PCI术后24 h心肌坏死标志物的升高实验组明显低;实验组患者术后6个月的MACE发生率明显下降;但出血发生率不增加。结论 NSTEACS患者围PCI手术期联合应用替罗非班和磺达肝癸钠可改善心肌灌注,减少CTFC、围PCI术期心肌损伤及MACE发生率。

Objective To assess the effect of administration of tirofiban and fondaparinux during percutaneous coronary intervention （PCI） in patients with non-STsegment elevation acute coronary syndrome （NSTEACS）. Methods Two hundred and eleven NSTEACS patients were continuously selected and randomly assigned into experimental group （105 patients, accepting perioperational administration of tirofiban and fondaparinux） and control group （106 patients, only accepting perioperational administration of fondaparinux）. We observed the corrected TIMI frame count （CTFC）, myocardial necrosis markers and MACE of 6 months after PCI. Results Compared with control group, experimental group was significantly improved in post-PCI CTFC. The elevation of myocardial necrosis markers 24 hours after PCI and incidence of MACE 6 months after PCI were significantly lower in experimental group. No significant difference was found in hemorrhage occurrence between the two groups. Conclusion Compared with only administration of fondaparinux, administration of tirofiban and fondaparinux during PCI in NSTEACS patients improves myocardial perfusion and CTFC, and reduces post-PCI myocardial injury and incidence of MACE after PCI.