冠脉内注射替罗非班治疗急性冠脉综合征介入术后无复流的有效性和安全性被引量：10

Efficacy and safety of intracoronary tirofiban on noreflow patients after PCI in acute coronary syndrome

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摘要目的评价冠脉内注射国产盐酸替罗非班对急性冠脉综合征(ACS)介入术后无复流患者TIMI血流的影响及安全性。方法ACS患者行支架植入术后判定无复流者46例,随机分为替罗非班组(冠脉内注射盐酸替罗非班10μg/kg)26例,硝酸甘油组(冠脉内注射硝酸甘油200μg)20例。观察给药后30minTIMI血流分级及校正的TIMI计帧数(CTFC),2d后安全性的终点及30d主要不良心血管事件(MACE)发生率。结果替罗非班组介入术后无复流患者TIMIⅢ级血流获得率显著高于硝酸甘油组(65%vs30%,P<0.05);校正的TIMI计帧数显示替罗非班组血流快于硝酸甘油组[(72±19)vs(93±22),P<0.01],两组患者30d的MACE发生率替罗非班组低于硝酸甘油组(4%vs20%),但差异未达到显著水平。替罗非班组出血不良反应较硝酸甘油组略高(12%vs10%),但差别无统计学意义,两组均未见血小板减少。结论冠脉内注射国产盐酸替罗非班治疗ACS介入术后无复流患者是有效和安全的。 AIM To evaluate the efficacy and safety of intracoronary tirofiban on TIMI flow in acute coronary syndrome （ACS） with no-reflow after PCI. METHODS Forty-six ACS patients with no-reflow after stenting were randomized to tirofiban group （intracoronary tirofiban, 10 μg/kg, n = 26） and nitroglyceride group （intracoronary nitroglyceride, 200 μg, n = 20）. Targets to be observed consisted of corrected TIMI frame count （CTFC） , TIMI flow at 30-minute post-medication, safety end-points of 2-day post-PCI and incidence of major adverse cardiovascular events （MACE） of 30-day post-PCI. RESULTS The TIMI 3 ratio in tirofiban group was markedly higher than that in nitroglyceride group （65% vs 30% , P 〈 0.05 ）. CTFC showed that the coronary blood flow in tirofiban group was faster than that in nitroglyceride group （72±19 vs 93 ±22, P〈0.01 ）. No significant difference was found in the incidence of MACE of 30-day post-PCI and bleeding events between tirofiban and nitroglyceride groups （4% vs 20% ; 12% vs 10% ）. No thrombocytopenia was observed in the two groups. CONCLUSION The administration of intracoronary tirofiban is effective and safe for ACS patients with no-reflow after PCI.

作者卫丽李学奇金恩泽王晓云

机构地区哈尔滨医科大学附属第四医院心脏中心

出处《心脏杂志》 CAS 2009年第1期66-68,共3页 Chinese Heart Journal

关键词急性冠脉综合征替罗非班无复流介入治疗 acute coronary syndrome tirofiban no-reflow percutaneous coronary intervention

分类号 R541.4 [医药卫生—心血管疾病]

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