替罗非班治疗围介入术期高危非ST段抬高型急性冠脉综合征的效果研究

摘要

Objective To explore the clinical efficacy of tirofiban in treatment of patients with high-risk non-ST-segment elevation of acute coronary syndrome (NSTE ACS),in order to improve the level of treatment effect. Methods 90 cases with high-risk NSTE ACS from January 2011 to April 2013 were randomly divided into control group and observation group. The control group were received treatments of conventional aspirin,clopidogrel, anticoagulation,coronary angiography (CAG)and percutaneous coronary intervention (PCI),while the observation group were added tirofiban therapy an the basis of control group. After the treatment,the differences of cardiovascular adverse events,thrombolysis in myocardial infarction (TIMI)flow grade and complications in both two group were observed and compared. Results There were significant differences in major adverse cardiovascular events in the distal vascular blockage,surgery without reflux,recurrent angina and myocardial infarction and post-PCI TIMI flow grade 2 and 3 (P<0.05),but not in bleeding complications,TIMI flow grade 0 and 1 before and after PCI treatment. Conclusion Tirofiban is safe and effective in treatment of high-risk NSTE ACS in interventional procedures. It can improve TIMI flow, increase tissue perfusion and reduce postoperative complications.%目的：探讨替罗非班治疗围介入术期高危非ST段抬高型急性冠脉综合征（non-ST-segment elevation of acute coronary syndrome，NSTE-ACS）的效果。方法随机选取2011年1月～2013年4月90例高危NSTE ACS患者为研究对象，分成2组。对照组予以常规的阿司匹林、氯吡格雷抗凝，行冠状动脉造影术（coronary angiography，CAG）和经皮冠状动脉介入术（percutaneous coronary intervention，PCI）治疗，观察组在对照组基础上加用替罗非班治疗。观察2组治疗后在心血管不良事件、心肌梗塞溶栓（thrombolysis in myocardial infarction，TIMI）血流分级、并发症上的差异。结果2组在主要心血管不良事件血管远端堵塞、术中无返流、再发心肌梗死及心绞痛和PCI后的TIMI血流分级中的2级、3级上比较差异均有统计学意义（P＜0.05），但在出血并发症、PCI前的TIMI血流分级和PCI后的TIMI血流分级0级和1级上比较无显著差异性。结论围介入术期应用替罗非班治疗高危NSTE-ACS安全有效，可改善TIMI血流，增加组织灌注，降低术后并发症。