河北医科大学学报

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替罗非班对急性非ST段抬高心肌梗死合并2型糖尿病患者介入术后心肌灌注的影响

  

  1. 河北医科大学第二医院心内科,河北 石家庄 050000;2.河北中医学院病理科,河北 石家庄 050200
  • 出版日期:2016-06-25 发布日期:2017-01-16
  • 作者简介:姜云发( 1972- ),男,河北南皮人,河北医科大学第 二医院副主任医师,医学博士,从事心血管内科疾病诊治研究。

Effects of Tirofiban on myocardial perfusion in patients with acute non-ST segment elevation myocardial infarction complicated with type 2 diabetes treated by percutaneous coronary intervention

  1. 1.Department of Cardiology, the Second Hospital of Hebei Medical University, Shijiazhaung
    050000,China;2.Department of Pathology, Hehei University of Chinese
    Medicine, Shijiazhuang  050200,China  
  • Online:2016-06-25 Published:2017-01-16

摘要: [摘要] 目的 探讨血小板糖蛋白 Ⅱb / Ⅲa 受体拮抗剂替罗非班对急性非 ST 段抬高心肌梗死( acutenon-ST
segmentelevationmyocardialinfarction , NSTEMI )合并 2 型糖尿病患者血小板功能及经皮冠状动脉介入治疗术后
心肌灌注的影响。方法 选择 115 例 NSTEMI 合并 2 型糖尿病患者,随机分为替罗非班组 59 例,对照组 56 例。测
定 2 组不同时间点血小板最大聚集率( maxplateletaggregationrate , MPAR );冠状动脉介入开通梗死相关血管,术
后对病变血管行心肌呈色分级( myocardialperfusiongrade , MPG )评价心肌微循环灌注情况,比较 2 组间差异。结
果 在应用替罗非班不同时间点后,替罗非班组 MPAR 明显低于对照组( P <0.01 );替罗非班组术后 MPG 比例明
显高于对照组( P <0.01 );
2 组出血并发症差异无统计学意义。结论 替罗非班可以有效迅速抑制 NSTEMI 合并 2
型糖尿病患者血小板聚集,改善该类患者术后心肌灌注,临床应用安全可行。

关键词: 心肌梗死;糖尿病, 2型;治疗结果

Abstract: Abstract] ObjectiveTo evaluate the effect of platelet glycoprotein Ⅱb/Ⅲa receptor blockade on platelet function and myocardial perfusion in patients with acute nonST segment elevation myocardial infarction(NSTEMI) complicated with type 2 diabetes mellitus(T2DM) treated by percutaneous coronary intervention(PCI).  MethodsA total of 115 patients with STEMI and T2DM were randomized assigned to receive either tirofiban and PCI(n=59) or PCI alone(n=56). The maximum platelet aggregation rate(MPAR) were measured in all patients. Trombolysis in myocardial infarction grade and the myocardial perfusion grade(MPG) were studied immediately after PCI. ResultsAt different time points in the application of tirofiban, MPAR in tirofiban group were much lower than those of control group(P<001). The proportion of MPG in tirofiban group was significantly higher than that in the control group(P<001). There was no significant difference in bleeding complications between 2 groups.  ConclusionTirofiban can effectively inhibit platelet aggregation in patients with NSTEMI complicated with T2DM, improve postoperative myocardial perfusion with clinical safety and feasibility.

Key words: myocardial infarction, diabetes mellitus, type 2, treatment outcome