CAJ | 학술논문

目的：对比观察冠状动脉复杂病变介入治疗术中及术后应用替罗非班的疗效和安全性。方法150例冠状动脉复杂病变患者，随机分为 A组（冠脉造影明确后即静脉应用替罗非班并行PCI治疗）和B组（PCI术后即刻应用替罗非班）。比较两组PCI术后 T IM I3级血流率、术后6～12h超敏肌钙蛋白（hs-T nT ）、术后1周左室射血分数、术后1个月内主要心血管事件及出血和血小板减少事件的发生率。结果 A组 PCI术后即刻 TIMI3级血流率有高于B组倾向72／75 vs 66／75，χ2＝3．26，P＝0．05），A组术后6h、12hhs-TnT浓度显著低于B组（94±12．8vs104±6．2pg／mL，P＜0．001；69±11．4 vs 78±13．2 pg／mL ，P＜0．001），其余观察指标两组间无显著差异（P＞0．05）。结论论复杂冠脉病变介入术中早期应用替罗非班较术后应用可能获得更好的心肌灌注水平，降低介入手术相关心肌损伤，不增加严重出血及血小板减少发生率。
목적：대비관찰관상동맥복잡병변개입치료술중급술후응용체라비반적료효화안전성。방법150례관상동맥복잡병변환자，수궤분위 A조（관맥조영명학후즉정맥응용체라비반병행PCI치료）화B조（PCI술후즉각응용체라비반）。비교량조PCI술후 T IM I3급혈류솔、술후6～12h초민기개단백（hs-T nT ）、술후1주좌실사혈분수、술후1개월내주요심혈관사건급출혈화혈소판감소사건적발생솔。결과 A조 PCI술후즉각 TIMI3급혈류솔유고우B조경향72／75 vs 66／75，χ2＝3．26，P＝0．05），A조술후6h、12hhs-TnT농도현저저우B조（94±12．8vs104±6．2pg／mL，P＜0．001；69±11．4 vs 78±13．2 pg／mL ，P＜0．001），기여관찰지표량조간무현저차이（P＞0．05）。결론론복잡관맥병변개입술중조기응용체라비반교술후응용가능획득경호적심기관주수평，강저개입수술상관심기손상，불증가엄중출혈급혈소판감소발생솔。
Objective To compare the safety and efficacy of two uses of tirofiban in the treatment of patients with complex coronary lesion undergoing percutaneous coronary intervention (PCI) .Meth-ods A total of 150 patients with complex coronary lesion was randomly divided into group A ( n=75 , received tirofiban during PCI) and group B (n=75 ,received tirofiban after PCI) .The safety and effi-cacy were analyzed and compared among the two groups .Results TIMI reperfusion 3 grades in group A were higher than that in group B (72/75 vs .66/75 ,χ2 =3 .26 ,P=0 .05) .Hs-TnT of 6h ,12h after PCI was significantly decreased in group A than that in group B (94 ± 12 .8 vs .104 ± 6 .2 pg/mL ,P<0 .001 ;69 ± 11 .4 vs .78 ± 13 .2 pg/mL , P< 0 .001) .After PCI ,left ventricular ejection fraction (LVEF) 1 week later ,major adverse cardiac events (MACE) within 30d ,bleeding and the platelet count have no significant difference between the two groups .Conclusion As compared with using tiro-fiban after PCI in patients with complex coronary lesion ,using tirofiban before PCI could improve my-ocardial perfusion and reduce PCI related myocardial injury ,but does not increase incidence of severe bleeding and platelet derision .