替罗非班对冠脉综合征患者经皮冠状动脉介入治疗后凝血功能的调控作用

Regulation Effect of Tirofiban Postoperative Coagulation after Percutaneous Coronary Intervention of Patients with Coronary Syndrome

目的研究替罗非班术后辅助干预对冠脉综合征患者经皮冠状动脉介入术(PCI)治疗后凝血功能的调控作用。方法选取我院2010年12月至2013年12月冠脉综合征患者98例,随机分为观察组与对照组两组,每组49例。观察组患者在PCI术后给予替罗非班辅助干预,对照组患者在PCI术后不给予辅助干预。比较两组患者手术前后血小板聚集率(PAg T)、活化凝血时间(ACT)、抗凝血酶(AT)、可溶性CD40配体(s CD40L)、基质金属蛋白酶-9(MMP-9)、高敏C反应蛋白(hs-CRP)等因子变化情况,比较两组患者术后部分凝血酶原时间(a PTT)、凝血酶原时间(PT)和凝血酶时间(TT)等凝血指标水平。结果观察组患者PAg T水平较对照组显著较低(P<0.05),ACT和血浆AT水平较对照组显著较高(P<0.05);观察组患者的s CD40L、Hs-CRP、MMP-9等血清炎性因子水平较对照组显著较低(P<0.05);观察组患者术后a PTT、PT、TT等凝血指标较对照组无差异(P>0.05)。结论冠脉综合征患者PCI介入治疗后给予替罗非班干预能抑制血小板聚集,有加强抗血小板的作用,患者血清中炎性因子水平降低,血管内皮功能得到改善。

Objective To explore regulation effect of tirofiban postoperative on coagulation after percutaneous coronary intervention( PCI) of patients with coronary syndrome. Methods 98 patients with coronary syndrome in our hospital from December 2010 to December 2013 were selected,they were divided by random lot method into the observation group and the control group( each 49 cases). The observation group was given tirofiban adjuvant intervention after PCI,the control group was not given adjuvant intervention after PCI. Platelet aggregation rate( PAg T),activated clotting time( ACT),changes of antithrombin( AT) levels,soluble CD40 ligand( s CD40L),matrix metalloproteinase-9( MMP-9),high-sensitive C-reactive protein( hsCRP) and other serum inflammatory factors changes in the two groups before and after the operation were compared,postoperative partial prothrombin time( a PTT),prothrombin time( PT),thrombin time( TT) and other coagulation index level in the two groups were compared. Results PAg T level in the observation group was significantly lower than the control group( P < 0. 05),ACT and plasm AT level were significantly higher than the control group( P < 0. 05); s CD40 L,Hs-CRP,MMP-9 and other serum inflammatory factors level in the observation group were significantly lower than the control group( P < 0. 05); postoperative a PTT,PT,TT in the observation group were no change than the control group( P > 0. 05). Conclusion Tirofiban intervention after PCI interventional therapy in patients with coronary syndrome can control platelet aggregation,it plays a role in strengthening anti- platelet,reduces patients ' inflammatory factors level in serum,can improve blood vessel endothelium function.