【摘要】 目的:探讨经皮冠状动脉介入(PCI)联合盐酸替罗非班治疗对老年急性冠脉综合征(ACS)合并糖尿病患者的疗效和安全性。方法:选择218例糖尿病合并ACS患者,被随机分为常规治疗组(107例,采用标准术式PCI治疗)和替罗非班组(111例,常规治疗组基础上给予冠脉替罗非班注射)。观察两组手术指标,以及住院期间出血事件、术后6个月内主要心血管不良事件(MACE)的发生率。结果:两组门球时间、支架置入数、支架置入长度等PCI手术指标相比较差异均无统计学意义(P均>0.05)。与常规治疗组比较,替罗非班组患者TIMI3级血流(75.70%比91.89%)、MBG2～3级(69.16%比85.56%)、术后90minST段回落>50%(77.57%比92.79%)比例均显著增加,校正TIMI帧数[(33.05±8.37)帧比(26.54±5.47)帧]显著减少(P均<0.01)。两组住院期间出血性事件发生率无显著差异(P=0.375)。替罗非班组6个月内MACE发生率显著低于常规治疗组(P=0.001)。结论:老年急性冠脉综合征患者在常规PCI治疗的基础上联合冠脉内注射替罗非班可显著改善术后心肌灌注水平,降低术后近期MACE的发生率,且未增加出血性事件发生率,安全性良好。更多还原

【Abstract】 Objective:To explore therapeutic effect of percutaneous coronary intervention(PCI)combined hydrochloride tirofiban on aged patients with acute coronary syndrome(ACS)complicated diabetes mellitus(DM)and its safety.Methods:A total of 218 ACS+ DM patients were selected.According to randomization method,they were divided into routine treatment group(n=107,received standard PCI)and tirofiban group(n=111,received tirofiban injection in coronary artery based on routine treatment group).Operation indexes,incidence rates of hemorrhage during hospitalization and major adverse cardiovascular events(MACE)within six months after PCI were observed and compared between two groups.Results:There was no significant difference in door-to-balloon time,number and length of implanted stents between two groups,P>0.05 all.Compared with routine treatment group,there were significant rise in percentages of TIMI grade 3 blood flow(75.70% vs.91.89%),MBG grade 2～3(69.16% vs.85.56%)and ST segment regression>50% within 90 min after PCI(77.57% vs.92.79%),and significant reduction in corrected TIMI frame count(CTFC)[(33.05±8.37)frames vs.(26.54±5.47)frames]in tirofiban group,P<0.01 all.There was no significant difference in incidence rate of hemorrhage events during hospitalization between two groups,P=0.375.Incidence rate of MACE within six months in tirofiban group was significantly lower than that of routine treatment group,P=0.001.Conclusion:Intracoronary tirofiban injection based on routine PCI can significantly improve postoperative myocardial perfusion level,reduce incidence rate of short-term MACE after PCI without increasing incidence rate of hemorrhage in aged ACS patients.Its safety is good.更多还原