| 摘要: |
| 目的观察冠状动脉注射替罗非班对急性ST段抬高型心肌梗死（STEMI）患者直接经皮冠状动脉介入（PCI）术中炎性介质表达的影响。方法采用随机抽样法将患者分为治疗组（46例）和对照组（37例）。采用酶联免疫吸附法检测直接PCI术中靶血管炎性介质IL-6及TXA2浓度，观察其在用药前后的变化。通过冠状动脉造影评估TIMI血流分级，PCI术后行心电图检查计算ST段回落幅度。结果经冠状动脉注射替罗非班后，治疗组IL-6、TXA2值与对照组比较差异均有统计学意义（t=2.968、2.358，P＜0.05或0.01）；TIMI血流改善较对照组明显（字2=4.273，P＜0.05），TIMI帧数少于对照组（t=2.062，P＜0.05）；治疗组心电图ST段回落较对照组明显（t=2.163，P＜0.05）。结论冠状动脉注射替罗非班通过抑制靶血管炎性介质IL-6及TXA2表达改善心肌灌注。相比静脉给药，冠状动脉注射替罗非班能更好地发挥抗血小板、抗炎特性，改善冠状动脉血流及心肌灌注。 |
| 关键词: 急性 ST 段抬高型心肌梗死 直接 PCI 替罗非班 炎性介质 |
| DOI： |
| 分类号: |
| 基金项目:金华市重点科技项目 |
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| Changes of pro-inflammatory factor levels after intracornary tirofiban administration during primary percutaneous coronary intervention in patients with ST-elevation acute myocardial infarction |
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ZHONG Ming, LIU Aixia, FU Shenwen, ZHENG Xinling, ZHU Yijun, XU Yuhong
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Jinhua Central Hospital
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| Abstract: |
| Objective To investigate the effects of intracoronary tirofiban administration on pro-inflammatory factor levels in target vessel in patients with ST-elevation acute myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Methods Eighty three STEMI patients undergoing PCI were randomly assigned in two groups: 46 patients received intracoronary tirofiban administration during the procedure as study group and 37 patients did not receive tirofiban as control group. IL-6 and TXA2 levels were measured immediately before the administration of tirofiban and after stent placement. Results IL-6 and TXA2 levels in target vessels after PCI were significantly lower in study group than those in
control group (t=2.968 and 2.358, P＜0.05 and 0.01, respectively). After the administration of intracoronary tirofiban, thrombolysis
in myocardial infarction (TIMI) flow grade significantly increased (字2=4.273, P＜0.05). TIMI frame count in intracoronary tirofiban group was better than that in control group (t=2.062, P ＜0.05). ST-segment resolution on electrocardiogram enlarged in intracoronary tirofiban group (t=2.163, P＜0.05). Conclusion Intracoronary administration of tirofiban can improve myocardial perfusion, which may be associated with inhibiting the pro-inflammatory factors (IL-6 and TXA2) levels in target vessel. |
| Key words: Acute ST-segment elevation myocardial infarction Primary percutaneous coronary intervention Tirofiban Pro-inflammatory factor |
