经快速交换球囊导管注射替罗非班联合硝普钠对择期PCI术中无复流的作用

Effects of tirofiban combined with nitroprusside injection through the rapid exchange balloon catheter on no-reflow phenomenon during elective PCI

目的探讨经自制带侧孔的快速交换球囊导管靶向注射替罗非班联合硝普钠对择期冠状动脉介入治疗(PCI)术中无复流(NR)的即刻疗效。方法选择2013年1月至2014年8月在该中心行择期PCI治疗中发生无复流的患者49例,随机分为经球囊导管给药组25例,经指引导管给药组24例。两组患者均给予替罗非班及硝普钠。评价给药前后冠状动脉血流心肌梗死溶栓试验(TIMI)分级及校正TIMI帧数(CTFC)。结果给药10min后,经球囊导管给药组有21例(84.0%)达到TIMI 3级血流,校正CTFC为(33.5±12.5)帧,而经指引导管给药组有13例(54.2%)达到TIMI 3级血流,CTFC为(41.9±15.3)帧,两组比较差异有统计学意义(P<0.05)。结论经自制带侧孔球囊导管靶向注射替罗非班联合硝普钠较经指引导管给药更能有效地改善择期PCI术中无复流患者冠状动脉的即刻血流。

Objective To investigate the effects of tirofiban combined with nitroprusside injection through the rapid exchange balloon catheter with self-made side holes on no-reflow （NR） phenomenon during elective percutaneous coronary intervention （PCD. Methods A total of 49 patients with NR phenomenon were randomly divided into the balloon catheter group （n=25） and the guiding catheter group （n= 24）. Tirofiban combined with nitroprusside were used in both groups. Thrombolysis in myocardial infarction （TIMI） grade and corrected TIMI frame count （CTFC） of target coronary artery at 10 minutes after administration were assessed. Results At 10 minutes after drugs injection,there were 21 （84.0%） patients with target of coronary TIMI 3 grade in the balloon catheter group, and 13 （54.2% ） patients in the guiding catheter group. The CTFC was （33.5± 12.5） frame in the balloon catheter group, and （41.9±15.3） frame in the guiding catheter group. The difference in TIMI and CTFC between the two groups was significantly （P〈0.05）. Conclusion Injection tirofiban combined with nitroprusside through the rapid exchange balloon cathe- ter with self-made side holes in NR patients during elective PCI might be feasible and effective.