急性冠状动脉综合征患者急诊介人治疗中冠状动脉内应用替罗非班的临床观察

目的观察急性冠状动脉综合征(ACS)患者经皮冠状动脉介入治疗(PCI)术中冠状动脉内应用替罗非班的疗效及安全性。方法选择住院接受急诊PCI治疗的ACS患者108例,随机分为观察组和对照组,所有患者均采用常规抗血小板治疗,观察组在此基础上于PCI术中病变血管内注射替罗非班。观察2组患者PCI术后冠状动脉TIMI血流分级,TIMI心肌灌注分级(TMPG),术后1周心脏超声左心室舒张末内径(LVEDD)、左心室射血分数(LVEF)等指标及术后出血并发症和主要心血管事件(MACE)发生率等。结果观察组PCI术后TIMI分级和TMPG分级Ⅲ级的比例均明显高于对照组(P<0.05);术后1周LVEF明显高于对照组(P<0.05),而LVEDD差异无统计学意义(P>0.05);2组患者术后出血事件发生率及MACE发生率比较差异均无统计学意义(P>0.05)。结论替罗非班在急诊PCI治疗ACS中可有效改善梗死相关血管血流灌注,减少术后无复流现象的发生,并且不增加出血风险。

Effects of intracoronary tirofiban during emergency intervention in patients with acute coronary syndrome

Objective To evaluate the effects of intracoronary tirofiban during emergency intervention in patients with acute coronary syndrome （ACS）. Methods A total of 108 patients with ACS who were treated with primary PCI were random- ly divided into two groups. All patients were given conventional antiplatelet therapy, and the observation group was treated with tirofiban combined with heparin saline by coronary injection at vascular lesions. The TIMI grade, TIMI myocardial perfu- sion grade （TMPG） after PCI, and the left ventricular end diastolic diameter （ LVEDD）, left ventricular ejection fraction （LVEF） and postoperative hemorrhage disease and the incidence of major adverse vascular events （MACE） were compared and analyzed. Results The ratio of grading 3 of TIMI and TMPG postoperative in observation group was significantly higher （ P 〈 O. 05 ） ; The LVEF after 1 week was significantly higher （ P 〈 0. 05） ; There were no significant difference in LVEDD, bleeding event rate and the MACE rate between the two groups （ P 〉 0.05 ）. Conclusion Tirofiban therapy in primary PCI on patients with ACS can effectively improve the infarct related artery blood flow perfusion, and reduce the occurrence of post- operative no reflow phenomenon, and the treatment is safe.