冠状动脉内注入替罗非班治疗急性冠脉综合征介入术后无复流的临床研究

Effect of Tirofiban by Injecting Through Coronary Artery on Patients With Acute Coronary Syndrome after PCI With No Reflow

目的评价冠状动脉内注入血小板GPⅡb/Ⅲa受体拮抗药替罗非班治疗急性冠脉综合征(ACS)患者介入术后无复流的临床疗效。方法介入术后无复流的ACS患者36例,随机分为替罗非班治疗组(n=20)和对照组(n=16),两组在常规应用抗凝、抗血小板治疗的基础上,治疗组给予冠状动脉内注入替罗非班8ml,观察用药后两组心电图、血小板聚集率及住院期间主要终点事件发生率。结果与对照组比较,治疗组心电图ST段明显改善,缺血损伤导联减少(P<0.05),血小板聚集率明显降低(P<0.05),住院期间主要终点事件发生率显著下降(P<0.05)。结论冠状动脉内注入血小板GPⅡb/Ⅲa受体拮抗药替罗非班通过抑制血小板聚集,加强微血管灌注,从而明显改善ACS介入术后无复流的现象。

Objective To investigate the clinical effect of platelet GP Ⅱb/Ⅲa receptor antagonist-Tirofiban by injecting through coronary artery on patients with acute coronary syndrome(ACS) with no reflow after PCI.Methods 36 patients with ACS with no reflow after PC1 were randomized to Timfiban group(n=20) and control group(n=16),basing on the regular therapy of anti coagulation and anti platelet.The Tirofiban group received injecting 8 ml Tirofiban through coronary artery.The ECG,the rate of platelet aggregation,the main end point events in hospital were observed.Results Compared with the control group,the Tirofiban group:ST segment apparently improved,and the ischemic segments decreased(P<0.05),the rate of platelet aggregation apparently decreased(P<0.05),the main end point events apparently decreased(P<0.05),the TIMI grade of forward flow apparently increased(P<0.05).Conclusion Tirofiban,a type of platelet GP Ⅱb/Ⅲa receptor antagonist,restrained the assembly of platelet,promoted the irrigation of microvessel,then it apparently improved the no reflow phenomenon of ACS after PCI by injecting through coronary artery.