替罗非班与维拉帕米治疗急性冠脉综合征介入术后无复流的临床疗效对比研究

目的对比观察替罗非班与维拉帕米治疗急性冠脉综合征(ACS)介入术后无复流的临床疗效。方法选取经皮冠状动脉介入术后无复流ACS患者60例随机分为替罗非班治疗组和维拉帕米治疗组。经冠状动脉给药后48h,观察并记录两组患者TIMI血流分级及心电图变化;术后2周,观察并记录心源性猝死、再发心绞痛、新发心肌梗死等心脏不良事件的发生率。结果替罗非班组TIMI血流0级、1级发生率显著低于维拉帕米组,TIMI血流2级、3级发生率显著高于维拉帕米组,两组比较差异有显著性(P0.05);替罗非班组心电图改善明显,与维拉帕米组比较差异有显著性(P0.05);术后2周替罗非班组不良心脏事件发生率显著低于维拉帕米组(P0.01)。结论替罗非班治疗急性冠脉综合征介入术后无复流现象安全有效,值得临床推广使用。

Contrast research of the effect of tirofiban and verapamil in acute coronary syndrome patients with no-reflow phenomenon after percutaneous coronary intervention

Objective To observe the clinical effect of tirofiban and verapamil in acute coronary syndrome（ ACS） patients with no-reflow phenomenon after percutaneous coronary intervention（ PCI）. Methods Sixty ACS patients who had no-reflow phenomenon during PCI were divided into verapamil treatment group and tirofiban treatment group. Two groups of patients were observed and recorded TIMI flow grade and ECG changes and the sudden cardiac death,recurrent angina,the incidence of new-onset myocardial infarction and other cardiac adverse events after two weeks. Results In tirofiban group the occurrence rates of TIMI grades 0 and 1 were significantly lower than those in verapamil group but the occurrence rates of TIMI grades 2 and 3 were significantly higher than those in verapamil group（ P 〈 0. 05）. The changes of ECG of tirofiban treatment group were significantly better than verapamil treatment group（ P 〈 0. 05）. Within 2 weeks after PCI,the major adverse cardiac events were less in tirofiban treatment group than those in verapamil treatment group（ P 〈 0. 01）. Conclusion The treatment with tirofiban through coronary artery can effectively relieve no-reflow phenomenon after PCI.