法舒地尔治疗急性冠脉综合征介入术后无复流的疗效

目的：观察Rho激酶抑制剂法舒地尔对急性冠脉综合征（ACS ）介入术后无复流的临床疗效。方法：住院行经皮冠状动脉介入（PCI）治疗后发生无复流的 ACS患者（82例）被随机分为法舒地尔组（30例，法舒地尔5mg），硝酸甘油组（25例，硝酸甘油200μg），替罗非班组（27例，替罗非班10ml），均在冠状动脉内注射药物，10min后复查冠脉造影并评定冠状动脉血流速度。观察TIMI血流改善情况、ST 段抬高及压低幅度、左室射血分数（LVEF）、主要不良心血管事件（MACE）发生率及并发症情况。结果：与硝酸甘油组比较，法舒地尔及替罗非班TIMI血流改善有效率（40.0％比63.3％、59.3％）、ST段抬高及压低幅度（0.15±0.09） mm比（0.24±0.11） mm、（0.26±0.15） mm]、LVEF水平（48.32±5.67）％比（56.12±7.11）％、（55.78±6.99）％]明显提高， MACE发生率明显下降， P＜0.05-＜0.01；在低血压、出血及血小板减少并发症方面，法舒地尔组并发症发生率（13.3％、6.7％、16.7％）均显著低于硝酸甘油组（68.0％、4.0％、12.0％）或替罗非班组（3.7％、29.6％、44.4％）， P均＜0.05。结论：法舒地尔治疗急性冠脉综合征介入术后无复流是安全有效的，值得推广。

Clinical therapeutic effect of Rho kinase inhibitor-fasudil on no-reflow in ACS patients after PCI

Objective：To observe the clinical therapeutic effect of Rho kinase inhibitor-fasudil on no-reflow in pa-tients with acute coronary syndrome （ACS） after percutaneous coronary intervention （PCI） .Methods ：A total of 82 ACS patients ,who hospitalized and occurred no-reflow after PCI ,were randomly divided into fasudil group （n=30 , received fasudil 5mg） ,nitroglycerin group （n=25 ,received nitroglycerin 200μg） and tirofiban group （n=27 ,re-ceived tirofiban 10ml） .All patients received drugs via intracoronary injection ,and reviewed coronary angiography and coronary blood flow velocity evaluation after 10min .Thrombolysis in myocardial infarction （TIMI） flow im-provement ,ST segment elevation/depression extent ,left ventricular ejection fraction （LVEF） ,incidence rates of major adverse cardiovascular events （MACE） and complications were observed .Results：Compared with nitroglycer-in group ,there were significant rise in effective rate of TIMI flow improvement （40.0% vs .63.3% ,59.3% ） ,ST segment elevation and depression extent （0.15 ± 0.09） mm vs .（0.24 ± 0.11） mm ,（0.26 ± 0.15） mm] and LVEF level （48.32 ± 5.67）% vs .（56.12 ± 7.11）% ,（55.78 ± 6.99）% ] ,and significant reduction in incidence rate of MACE in fasudil group and tirofiban group , P〈0.05- 〈0.01 ;for complications of hypotension ,hemorrhage and thrombocytopenia ,incidence rates of fasudil group （13.3% ,6.7% ,16.7% ） were significantly lower than those of nitroglycerin group （68.0% ,4.0% ,12.0% ） or tirofiban group （3.7% ,29.6% ,44.4% ） , P〈0.05 all .Conclu-sion：Fasudil is safe and effective on no-reflow after PCI in ACS patients ,and it is worthy of extension .