微创医学

目的评价替罗非班对急性冠状动脉综合征（ACS）PCI术后无复流及hs-CRP的影响。方法ACS接受PCI治疗并出现无复流现象的68例患者，随机分为替罗非班组35例和对照组33例，对照组给予维拉帕米治疗，替罗非班组给予替罗非班治疗，观察首次给药后5 min和PCI结束前末次造影时TIMI血流分级，术前、术后2 h、术后6 h hs-CRP水平及心脏不良事件发生率。结果首次给药后5 min、PCI结束前末次造影时，替罗非班组患者TIMI 3级患者比例均明显高于对照组（P＜0.05）；术前两组hs-CRP比较，差异无统计学意义（P＞0.05）；术后2 h、术后6 h替罗非班组患者hs-CRP水平均明显低于对照组（P＜0.05）；随访2个月中，替罗非班组发生心脏不良事件4例，对照组发生心脏不良事件11例，两组比较，差异有统计学意义（P＜0.05）。结论替罗非班能有效治疗ACS患者PCI术后无复流现象，改善炎症反应，值得临床推广应用。

ObjectiveTo evaluate the influences of tirofiban on no-reflow after PCI and serum hs-CRP in patients with acute coronary syndrome(ACS). MethodsA total of 68 ACS patients with no-reflow after PCI were randomly divided into tirofiban group(n=35) and control group(n=33).Verapamil was used in Control group and tirofiban was used in tirofiban group. TIMI grade was observed immediately by angiography in 5 minute after first administration and before the end of PCI,The serum hs-CRP of preoperative,after 2h and 4h of PCI, and incidence of major adverse cardiovascular events(MACE) were recorded. ResultsTIMI 3 grade flow in 5 minute after first administration and before the end of PCI in the tirofiban group were higher than that in control group(P＜0.05). The level of serum hs-CRP was no significant difference between two group before operate(P＞0.05);After 2h and 6h of PCI，the level of serum hs-CRP in the tirofiban group were lower than that in control group(P＜0.05). Followed up for 2 months,there was 4 cases of MACE in tirofiban group,and 11 cases of MACE in control group,there was significant difference between two groups(P＜0.05). ConclusionsTirofiban has definite effect on patients with no-reflow after PCI, and can improve the inflammatory response; it’s worth of clinical promotion.