替罗非班对急性冠脉综合征患者PCI术后慢血流/无复流的影响及安全性

Effect and safety of tirofiban on slow flow/no reflow after PCI in patients with acute coronary syndrome

目的探讨替罗非班对急性冠脉综合征(ACS)患者PCI术后慢血流/无复流的影响及安全性。方法将2016年1月至2018年6月我院收治并行PCI术治疗的86例ACS患者按照随机数字表法分为观察组(n=44)和对照组(n=42)。观察组在PCI术中经冠脉缓慢注入替罗非班,对照组术中经冠脉内直接注入维拉帕米。比较两组不同时间TIMI血流分级、cTFC、LVEF、左室舒张末期内径及不良反应发生情况。结果冠脉内注药后首次及PCI术毕前末次,观察组患者TIMI血流分级及cTFC均优于对照组(P<0.05);术后7d,两组患者的LVEF及左室舒张末期内径均优于术前,且观察组优于对照组(P<0.05)。结论冠脉内注入替罗非班能有效减少ACS患者经PCI治疗后慢/无复流的发生,效果较好,且安全性较高,值得临床推广。

Objective To investigate the effect and safety of tirofiban on slow flow/no reflow after PCI in patients with acute coronary syndrome (ACS). Methods From January 2016 to June 2018, 86 patients with ACS who underwent PCI in our hospital were divided into observation group (n=44) and control group (n=42) according to the random number table method. Tirofiban was slowly injected into coronary artery in the observation group, and verapamil was directly injected into coronary artery in the control group. The TIMI flow grades, cTFC, LVEF, left ventricular end diastolic diameter at different time and adverse reactions were compared between the two groups. Results The TIMI flow grades and cTFC at first time after intracoronary injection and last time before the completion of PCI in the observation group were superior to those in the control group (P<0.05). At 7 days after operation, the LVEF and left ventricular end diastolic diameter in both groups were better than those before operation, and those in the observation group were better than the control group (P<0.05). Conclusion Tirofiban injected into coronary artery can effectively reduce the incidence of slow flow/no reflow in patients with ACS treated by PCI, with good effects and high safety, which is worthy of clinical promotion.