不同时间窗应用替罗非班对PCI术中无复流的疗效观察

选择经皮冠状动脉介入治疗( PCI )术中因急性血栓形成出现无复流的急性冠脉综合征( ACS)患者128例,随机分为两组,各64例,均冠脉内推注负荷量替罗非班,A组：通过导丝、球囊或使用球囊预扩后出现心肌梗死溶栓治疗临床试验血流分级( TIMI)≥1级血流时经指引导管给药,或经上述处理后仍无前向血流时经微导管给药；B组：无前向血流时直接经指引导管给药。观察PCI 术后靶血管即刻血流,术后3 d症状改善及30 d主要心血管不良事件( MACE)的发生率。结果显示A组术中血流恢复情况、术后3d症状改善情况均优于B组(P<0．05),术后1个月MACE发生比率低于B组(P<0．05)。 A组方法可以更好地逆转无复流,减少患者术后不适症状及短期主要不良心脏事件的发生率。

Effects of tirofeban administrated at various time points on no-reflow phenomenon during PCI

128 patients who had no-reflow due to acute thrombosis during PCI were selected. Patients were random-ized into two groups with 64 cases in each group. All people bolus loading tirofiban in coronory artery. Group A:Tirofeban was injected via guiding catheter when TIMI grade was≥1 after passing-through of guidewire,balloon or pre-dilatation of balloon, or injection via microcatheter when there was no antegrade flow after aforementioned man-agement;Group B:Tirofeban was directly injected via guiding catheter when no-reflow occurred. Immediate blood flow in target vessel after PCI, improvement of symptoms 3 days after procedure as well as 30-day major adverse cardiovascular events ( MACE) were assessed. Results were that intraprocedural blood flow recovery and symptom improvement 3 days after procedure were better in Group A than in Group B with statistical significance ( P <0. 05 );the incidence of 30-day MACE was lower in Group A than that in Group B with statistical significance ( P<0. 05). The methods of group A may reverse no-reflow,reduce symptomatic discomfort as well as lower short-term MACE incidence more than group B.