冠脉内注射替罗非班治疗老年急性冠脉综合征的研究

目的：评价冠状动脉内注射替罗非班在老年急性冠脉综合征（ACS）介入治疗中的疗效和安全性。方法：102例ACS患者根据冠脉介入术中是否冠脉内应用替罗非班分为标准治疗组（50例）和替罗非班组（52例），对比两组介入治疗术后梗塞相关血管的TIMI分级、校正的TIMI计帧数和相关血管支配心肌的Blush分级，观察两组患者住院期间主要心血管事件和出血情况。结果：冠脉介入术后TIMI3级血流获得率替罗非班组明显高于标准治疗组（94．2％：76．0％，P〈O．05），TIMI计帧数显示替罗非班组血流快于标准治疗组（21．9±8．7）帧：（30．8±3．6）帧]，P〈0．05；而替罗非班组心肌Blush分级3级获得率明显高于标准治疗组（75．0％：32．0％，P〈0.01）。两组住院期间主要心血管事件发生率无显著性差异（P〉0．05）。替罗非班组出血发生率高于标准治疗组，但差异无显著性（P〉0.05）。结论：初步研究表明，在老年急性冠脉综合征介入治疗中冠脉内注射替罗非班是安全的，可以明显改善PCI术后的冠脉血流和心肌灌注。

Efficacy and safety of intracoronary use of tirofiban in elderly patients with acute coronary syndrome treated with percutaneous coronary intervention

Objective： To assess the clinical effect and safety of intracoronary use of tirofiban in elderly patients with a- cute coronary syndrome （ACS） treated with percutaneous coronary intervention （PCI）. Methods： A total of 102 ACS patients were divided into tirofiban group （n= 52） and normal group （n= 50） according to whether intracoronary using tirofiban, compared with each other for TIMI grade, corrected TIMI frame count （CTFC） and myocardial blush grade of related vascular after PCI operation, observed major advance cardiac effect and bleeding case. Results： There was more percentage of TIMI 3 flow achieved in tirofiban group after PCI （94. 2% ： 76.0%, P〈0.05）. Fewer TIMI frames （21.9±8.7） frames ： （30.8±3.6） frames, P〈0.05; and higher percentage of blush grade 3 of related vascular （75.0% ： 32.0%, P〈0.01） achieved in tirofiban group. There was no significant difference between the two groups in occurrence of MACE or bleeding in both groups （P〉0.05）. Conclusion： Intracoronary using of tirofiban during PCI in the elderly patients with ACS was safe and effective, which improves microvascular perfusion.