替罗非班不同给药途径对DM合并急性STEMI患者PCI术后血小板α-颗粒膜蛋白及心肌灌注水平的影响

The Effects of Tirofiban's Different Routes of Administration on Diabetic Patients' Levels of Plateletα-granule Membrane Protein and Myocardial Perfusion with Acute ST-segment Elevation Myocardial Infarction after Percutaneous Coronary Intervention

为探讨替罗非班不同给药途径对糖尿病(DM)合并急性ST段抬高型心肌梗死(STEMI)患者PCI术后血小板α-颗粒膜蛋白及心肌灌注水平的影响,对149例DM合并急性STEMI患者进行研究,测定并比较经静脉(A组)、冠脉给药途径(B组)和无替罗非班(C组)的患者术前及术中应用替罗非班后血小板α-颗粒膜蛋白GMP140浓度、造影结果、心肌酶及肌钙蛋白I水平峰值及峰值时间、心电图变化。结果显示A、B两组术中血小板α-颗粒膜蛋白浓度较术前明显降低(P<0.05),且B组较A组降低更明显(P<0.05),而C组未见明显变化(P>0.05),A、B两组术后即刻TIMI血流、2h sumSTR、心肌酶及肌钙蛋白I峰值及峰值时间的变化均优于C组(P<0.05),且B组优于A组(P<0.05)。因此,替罗非班可以降低血小板α-颗粒膜蛋白浓度和改善心肌灌注水平,与静脉途径给药相比,经冠脉给药更具有优势。

In order to investigate the effects of Tirofibans different routes of administration on diabetic patients＇ levels of platelet a-granule membrane protein and myocardial perfusion with acute ST-segment elevation myocardial infarction after percutaneous coronary intervention, 149 cases were investigated, determining and comparing the concentration of platelet a-granule membrane protein GMP140, the result of angiography, the peak level and time of cardiac enzymes and troponin I, ECG between preoperative and intraoperative application of Tirofiban among intravenous route of administration （group A）, coronary artery route （group B） and no tirofiban （group C）. The results showed that the intraoperative concentration of platelet α-granule membrane protein was significantly lower than preoperative in group A and B （P〈0.05）, and group B decreased significantly （P〈0.05） than group A, while group C had no significant change （P〉0.05） ; The immediate postoperative TIMI flow, 2h sumSTR, the peak level and time of cardiac enzymes and troponin Ⅰ of group A and B changed more significantly than group C （P〈0.05）, and group B is better than A （P〈0. 05）. Tirofiban can reduce platelet α-granule protein concentration and improve myocardial perfusion＇s levels. Compared with the intravenous route of administration, intracoronary administration has more advantages.