中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2014年
7期
44-47
,共4页
张磊%武子举%孙鸿彬%彭旭晖
張磊%武子舉%孫鴻彬%彭旭暉
장뢰%무자거%손홍빈%팽욱휘
替罗非班%经皮冠状动脉介入术%急性冠脉综合征%血小板
替囉非班%經皮冠狀動脈介入術%急性冠脈綜閤徵%血小闆
체라비반%경피관상동맥개입술%급성관맥종합정%혈소판
Tirofiban%Percutaneous coronary intervention%Acute coronary syndrome%Platelets
目的 探讨PCI术前应用替罗非班对急性冠脉综合征患者介入治疗的疗效和安全性及临床使用替罗非班的最佳时机.方法 观察三组血小板聚集率(PAR)、PCI术前后肌酸激酶同工酶(CK-MB)及TIMI血流情况,7d、30 d及90 d及主要心脏不良事件(MACE、死亡、再次心肌梗死和复发心肌缺血)、急性血栓事件和出血事件与血小板减少症的发生率.结果 应用替罗非班(PCI术前应用和PCI术后即刻应用)显著降低了术后24 hCK-MB水平的升高,较未应用组差异有统计学意义(10.30±1.49 vs 13.30±1.49 vs 17.50±3.24,P=0.001).PCI术前应用组与PCI术后即刻应用组和未应用组相比,术前靶血管的TIMI3级血流的获得率明显较高(51.2％ vs 29.1％ vs 34.3％,P=0.028).三组PCI术后7d、30d及90 d MACE事件发生率比较差异均无统计学意义,但PCI术前应用组较其他两组的发生率低.三组无GUSTO重度和中度出血的发生,轻度出血与血小板减少症的发生率比较差异也无统计学意义.结论 PCI术前应用替罗非班可有效地抑制中高危急性冠脉综合征患者血小板的聚集水平,改善PCI术前TIMI血流、减少术后心肌损伤和急性血栓事件的发生,并有进一步降低术后MACE发生率的趋势.
目的 探討PCI術前應用替囉非班對急性冠脈綜閤徵患者介入治療的療效和安全性及臨床使用替囉非班的最佳時機.方法 觀察三組血小闆聚集率(PAR)、PCI術前後肌痠激酶同工酶(CK-MB)及TIMI血流情況,7d、30 d及90 d及主要心髒不良事件(MACE、死亡、再次心肌梗死和複髮心肌缺血)、急性血栓事件和齣血事件與血小闆減少癥的髮生率.結果 應用替囉非班(PCI術前應用和PCI術後即刻應用)顯著降低瞭術後24 hCK-MB水平的升高,較未應用組差異有統計學意義(10.30±1.49 vs 13.30±1.49 vs 17.50±3.24,P=0.001).PCI術前應用組與PCI術後即刻應用組和未應用組相比,術前靶血管的TIMI3級血流的穫得率明顯較高(51.2％ vs 29.1％ vs 34.3％,P=0.028).三組PCI術後7d、30d及90 d MACE事件髮生率比較差異均無統計學意義,但PCI術前應用組較其他兩組的髮生率低.三組無GUSTO重度和中度齣血的髮生,輕度齣血與血小闆減少癥的髮生率比較差異也無統計學意義.結論 PCI術前應用替囉非班可有效地抑製中高危急性冠脈綜閤徵患者血小闆的聚集水平,改善PCI術前TIMI血流、減少術後心肌損傷和急性血栓事件的髮生,併有進一步降低術後MACE髮生率的趨勢.
목적 탐토PCI술전응용체라비반대급성관맥종합정환자개입치료적료효화안전성급림상사용체라비반적최가시궤.방법 관찰삼조혈소판취집솔(PAR)、PCI술전후기산격매동공매(CK-MB)급TIMI혈류정황,7d、30 d급90 d급주요심장불량사건(MACE、사망、재차심기경사화복발심기결혈)、급성혈전사건화출혈사건여혈소판감소증적발생솔.결과 응용체라비반(PCI술전응용화PCI술후즉각응용)현저강저료술후24 hCK-MB수평적승고,교미응용조차이유통계학의의(10.30±1.49 vs 13.30±1.49 vs 17.50±3.24,P=0.001).PCI술전응용조여PCI술후즉각응용조화미응용조상비,술전파혈관적TIMI3급혈류적획득솔명현교고(51.2％ vs 29.1％ vs 34.3％,P=0.028).삼조PCI술후7d、30d급90 d MACE사건발생솔비교차이균무통계학의의,단PCI술전응용조교기타량조적발생솔저.삼조무GUSTO중도화중도출혈적발생,경도출혈여혈소판감소증적발생솔비교차이야무통계학의의.결론 PCI술전응용체라비반가유효지억제중고위급성관맥종합정환자혈소판적취집수평,개선PCI술전TIMI혈류、감소술후심기손상화급성혈전사건적발생,병유진일보강저술후MACE발생솔적추세.
Objective To observe the safety and efficacy of tirofiban before PCI for acute coronary syridrome,and the best time of tirofiban in clinics.Methods The platelet aggregation rate (PAR),MB isoenzyme of creatine kinase (CK-MB) and TIMI 3 flow rate before and after PCI,incidences of 7-day,30-day and 90-day major adverse cardiac events (MACE,death,reinfarction,recurrent myocardial ischemia),acute thrombotic events,bleeding complications and thrombocytopenia were recorded.Results Application of tirofiban (applications before PCI and applications immediately after PCI) significantly reduced MB isoenzyme of creatine kinase after PCI 24 hours(10.30 ± 1.49 vs 13.30 ± 1.49 vs 17.50 ±3.24,P =0.001).Before PCI,TIMI 3 flow rate of the target vessel was significantly higher in tirofiban before PCI group than that in downstream tirofiban and no tirofiban groups (51.2％ vs 29.1％ vs 34.3％,P =0.028).There was no significant difference among the three groups in the 7-day,30-day and 90-day occurrences of MACE,through the incidences were consistently lower in tirofiban before PCI.No GUSTO severe or moderate bleeding was observed.The incidences of slight bleeding complications and thrombocytopenia were not significantly different among the three groups.Conclusions Tirofiban before PCI is associated with potently inhibition of platelet aggregation,a better patency (TIMI 3 flow) before PCI,attenuated minor myocardial damage,the lower occurrence of acute thrombosis events and the tendency of reducing incidences of MACE.
