论文部分内容阅读
目的:初步评价经皮冠状动脉介入(PCI)治疗不稳定型心绞痛(UAP)应用替罗非班易化的有效性和安全性。方法:80例接受PCI治疗的中高危UAP患者,随机分为替罗非班组(38例)和对照组(42例)。对照组未使用替罗非班,替罗非班组患者入院时即静脉应用并于PCI术后持续静滴注36h,比较2组基础临床情况、支架置入数及靶血管置入支架后血流TIMI分级、血流速度、校正的TIMI帧数(CTFC)及出血并发症和术后30d主要心血管不良事件(MACE)。结果:2组的基础临床情况差异无统计学意义。与对照组相比,术后替罗非班组中靶血管的TIMI 3级血流获得率更高,但差异无统计学意义(88.00%∶73.91%,P>0.05);无复流发生率明显减少,差异具有统计学意义(4.00%∶17.39%,P<0.05);替罗非班组的血流速度明显增快[(137.12±19.65)mm/s∶(123.46±21.35)mm/s,P<0.01];CTFC减小[(20.36±2.52)帧∶(24.52±3.43)帧,P<0.01]。2组的出血并发症和术后30dMACE发生率差异无统计学意义。结论:对于中高危UAP患者行PCI,早期使用替罗非班能显著减少无复流现象,提高前向血流,改善术后心肌灌注,并不增加出血风险,临床应用安全。
Objective: To evaluate the efficacy and safety of percutaneous coronary intervention (PCI) for the treatment of unstable angina pectoris (UAP) with tirofiban. Methods: Eighty high-risk UAP patients undergoing PCI were randomly assigned to tirofiban (n = 38) and control (n = 42). Tirofiban was not used in the control group. Patients in the tirofiban group were intravenously administered on admission and continued intravenously for 36 hours after PCI. The basic clinical situation, stent placement, and post-stent blood flow of the target vessel were compared TIMI grade, blood flow velocity, corrected TIMI frames (CTFC), and bleeding complications and major cardiovascular events 30 days after surgery (MACE). Results: There was no significant difference in the basic clinical conditions between the two groups. Compared with the control group, the TIMI 3 blood flow rate of target vessel in Tilofiban group was higher than that of the control group, but the difference was not statistically significant (88.00%: 73.91%, P> 0.05). The incidence of no-reflow was significantly higher (P <0.05). The blood flow velocity in tirofiban group was significantly higher than that in tirofiban group [(137.12 ± 19.65) mm / s: (123.46 ± 21.35) mm / s, P <0.01]; CTFC decreased [(20.36 ± 2.52) frames: (24.52 ± 3.43) frames, P <0.01]. No significant difference was found between the two groups in bleeding complications and the incidence of postoperative 30dMACE. Conclusion: The early use of tirofiban can significantly reduce the no-reflow phenomenon, improve the antegrade blood flow, improve the postoperative myocardial perfusion, and do not increase the risk of bleeding, and its clinical application is safe.