替罗非斑对介入治疗后支架内亚急性血栓形成的影响研究

目的：探讨替罗非斑对经皮冠状动脉介入治疗 （PCI） 后支架内亚急性血栓形成的影响.方法：将 45 例支架内亚急性血栓形成患者随机分为观察组和对照组,观察组在盐酸替罗非斑 10 μg/kg 3 min 静脉推注,继以 0.15 μg/（kg·min） 持续点滴后,行急诊 PCI,术后继续维持 48 h;对照组直接再次行急诊 PCI.结果：观察组中 26 例 ST 段回落,对照组 4 例 ST 段回落,两组比较,差异有统计学意义 （P〈0.05） ;观察组 TIMI血流 2～3 级者 24 例,对照组 6 例,两组比较,差异有统计学意义 （P〈0.05）;观察组轻、中度出血发生率多于对照组,差异有统计学意义 （P〈0.05）;两组均未出现严重出血.结论：PCI 联合静脉推注大剂量替罗非斑,能缓解患者胸痛的症状,改善心电图及心肌酶谱情况,改善冠脉血流,从而减少亚急性支架内的血栓量,化解清除部分或全部支架内的血栓,临床效果好,值得推广应用.

The Effect of Tirofiban on Stent Subacute Thrombosis After Percutaneous Coronary Intervention

Objective： To investigate the effect of tirofiban on stent subacute thrombosis after percutaneous coronary intervention（PCI）. Method： 45 patients were divided randomly into two groups. The observation group received tirofiban hydrochloride 10 μg/kg intravenous injection, within 3 min then 0.15 μg/（kg · min） continuous drip, emergency PCI. The control group received emergency PCI directly again. Result： There were 26 cases in the observation group got ST segment resolution, which 4 cases in control group. There were 24 cases in the observation group, whose TIMI level was 2-3, which 4 cases in control group. The light, moderate bleeding rate of the control group was more than that of observation group. There was statistical significance between the two groups（P〈0.05）. No severe bleeding happened in both the two groups. Conclusion： PCI combined with intravenous injection of large dose of tirofiban in patients with chest pain, can alleviate the symptoms, improve the electrocardiogram and myocardial enzyme spectrum, improves coronary blood flow, thus can reduce the stent subacute thrombosis, dissolve the removal of part or all of stent thrombosis, and has good clinical effect, which is worth promoting the application.