盐酸吡格列酮对糖耐量减低患者血浆内皮素、一氧化氮、C反应蛋白的影响

目的观察糖耐量减低患者应用盐酸吡格列酮治疗前后血浆内皮素（ET）、一氧化氮（NO）、C反应蛋白（CRP）水平变化。方法口服75g葡萄糖耐量试验筛查出糖耐量减低患者82例，并对其进行为期15周的随机、双盲、安慰剂对照、盐酸吡格列酮干预治疗试验。随机分为吡格列酮组（55例）和安慰剂组（27例）。观察治疗前后两组ET、NO、CRP变化情况。结果吡格列酮组治疗后ET、CRP、NO分别为（55．1±10．1）ng／L、（4．59±0．33）mg／L、（40．10±10．10）μmol／L]与治疗前分别为（72．1±25．1）ng／L、（5．89±0．89）mg／L、（30．30±9．10）μmol／L]比较差异有统计学意义（P〈0．01）。安慰剂组三者均无显著性改变。结论糖耐量减低患者应用盐酸吡格列酮治疗后其ET、NO、CRP水平可显著改善。

Effect of intracoronary tirofiban in patients undergoing primary percutaneous coronary intervention for acute myocardial infarction

Objective To investigate the efficacy of intracoronary tirofiban during percutaneous coronary intervention(PCI)for patients with acute myocardial infarction(AMI).Methods Seventy-six consecutive AMI patients,treated with primary coronary angioplasty in 12 hours were enrolled.They were randomly divided into two groups:tirofiban group(39 cases)and control group(37 cases).Tirofiban group was treated with intracoronary timfiban during PCI and after the operation for 48 hours.Both of them were given heparin in PCI and aspirin,clopidogrel before PCI.At the end of PCI procedure,angiographic features such as TIMI flow grade and TIMI myocardial perfusion grade(TMPG)were analyzed.The difference of two groups in complication and major adverse cardiac events(MACE) was investigated.Results The myocardial reperfusion of tirofiban group was better than that of control groupTIMI grade 3 flow 94.9%(37/39) vs 78.4%(29/37),P<0.05;TMPG 3 grade 89.7%(35/39)vs 67.6%(25/37),P<0.05].There was no significant difference between two groups in bleeding complication.The occurrence of MACE in tirofiban group was less than that in control group7.7%(3/39)vs 18.9%(7/37),P<0.05].Conclusion Intracoronary tirofiban dunng primary PCI in patients with AMI can improve coronary flow and myocardial perfusion,and has no more bleeding and less MACE occurrence.