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目的评价冠状动脉内注射国产盐酸替罗非班对急性冠状动脉综合征(acute coronary syn-drome,ACS)介入术后无复流患者冠状动脉TIMI血流的影响安全性及可行性。方法将ACS患者经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后判定无复流者67例,分为A组(冠状动脉内注射维拉帕米200μg及盐酸替罗非班10μg/kg)32例和B组(冠状动脉内注射维拉帕米200μg)35例。观察给药后10min TIMI血流分级及校正的TIMI计帧数(CTFC),出血并发症及30d内主要不良心血管事件(MACE)发生率。结果 A组介入术后无复流患者TIMIⅢ级血流获得率(65.6%)高于B组(42.9%)(P<0.05);CTFC显示替罗非班组血流快于维拉帕米组(P<0.01);出血并发症发生率和30d内MACE发生率与维拉帕米组差异均无统计学意义(P>0.05)。结论冠状动脉内注射国产盐酸替罗非班治疗ACS介入术后无复流患者是有效和安全可行的。
Objective To evaluate the safety and feasibility of intracoronary injection of domestic tirofiban hydrochloride on TIMI flow in coronary arteries of patients with no-reflow after acute coronary syndrome (ACS) intervention. Methods Sixty-seven patients with no-reflow after PCI underwent percutaneous coronary intervention (PCI) were divided into two groups: group A (200μg of verapamil and 10μg / kg of tirofiban hydrochloride ), 32 cases and group B (intravitreal injection of verapamil 200μg) in 35 cases. TIMI flow grade and corrected TIMI frame count (CTFC), bleeding complications and major adverse cardiovascular event (MACE) incidence within 30 days were observed 10 min after administration. Results The TIMI Ⅲ grade blood flow rate (65.6%) was significantly higher in group A than in group B (42.9%) (P <0.05). CTFC showed that the blood flow of tirofiban group was faster than that of verapamil group P <0.01). There was no significant difference in the incidence of bleeding complications and MACE incidence between 30 days and verapamil (P> 0.05). Conclusion Intracoronary injection of domestic tirofiban hydrochloride is effective and safe for patients with no-reflow after ACS intervention.