冠状动脉内推注大剂量替罗非班治疗冠状动脉介入术中无复流

Efficacy of intracoronary large dose of tirofiban on no-reflow phenomenon during percutaneous coronary intervention

目的：探讨冠状动脉内注射大剂量替罗非班对冠状动脉介入（PCI）术中无复流（NRP）的临床疗效。方法：本文报道一组急性冠脉综合征（ACS）患者PCI术时发生无复流,迅速使用冠脉内注射替罗非班治疗。结果：大剂量替罗非班（41~120 g/kg,平均66 g/kg）冠脉内注射,迅速改善冠脉血流分级;除3例患者出现皮肤黏膜小出血外,未见明显出血并发症发生。结论：冠脉内推注替罗非班可成为一种治疗PCI术中冠脉无复流的有效策略,尤其对那些合并血流动力学异常的危重病例,可从大剂量冠脉内应用替罗非班的治疗中获益。

Objective： To explore the clinical therapeutic effect of intracoronary large dose of triofiban on no-reflow phenomenon during percutaneous coronary intervention（ PCI）. Methods： We present a set of acute coronary syndrome（ ACS）patients who developed no-reflow phenomenon during PCI. All patients were treated with intracoronary administration of tirofiban. Results： Intracoronary administration of large dose of tirofiban（ 41 ~ 120 g / kg,mean dose 66 g / kg） immediately restored the coronary flow. There was no significant bleeding complications observed except for minor skin and mucosa bleedings in 3 patients. Conclusion： Our experience suggests that intracoronary administration of tirofiban can be considered as an option for the treatment on no-reflow phenomenon during PCI. More importantly,in those patients with critical hemodynamic disorders will benefit from administration of large dose of tirofiban.