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目的研究血小板糖蛋白(GP)Ⅱb/Ⅲa受体拮抗剂在老年冠脉介入(PCI)再灌注损伤(MIRI)中的疗效。方法 141例老年急性冠脉综合征(ACS)行PCI患者,随机分成试验组和对照组,试验组术前给予常规药物+GPⅡb/Ⅲa受体拮抗剂,对照组术前给予常规药物+安慰剂,观察支架植入后即刻冠脉造影及术后1周心电图、动态心电图和超声心动图结果。结果对照组共9例(13.0%)有MIRI,试验组共2例(2.8%)有MIRI,2组比较TIMI血流有统计学差异(P<0.05),对照组心肌梗死再发、恶性心律失常、心源性休克的发生率较高。结论 GPⅡb/Ⅲa受体拮抗剂能明显改善老年PCI患者的MIRI,也提示血小板激活是这类患者的重要形成因素。
Objective To investigate the efficacy of platelet glycoprotein (GP Ⅱb / Ⅲa) receptor antagonists in elderly patients with coronary artery occlusion (PCI) and reperfusion injury (MIRI). Methods A total of 141 elderly patients with acute coronary syndrome (ACS) undergoing PCI were randomly divided into experimental group and control group. The experimental group was given conventional drugs and GPⅡb / Ⅲa receptor antagonist before operation. The control group was given conventional drugs and placebo The coronary angiography immediately after stent implantation and 1 week postoperative electrocardiogram, Holter monitoring and echocardiography were observed. Results There were MIRI in 9 cases (13.0%) in the control group, MIRI in 2 cases (2.8%) in the experimental group, TIMI blood flow in the 2 groups (P <0.05), and myocardial infarction in the control group Abnormal, high incidence of cardiogenic shock. Conclusion GPⅡb / Ⅲa receptor antagonist can significantly improve the MIRI in elderly patients with PCI, also suggests that platelet activation is an important factor in this type of patients.