上海交通大学学报（医学版）

›› 2011, Vol. 31 ›› Issue (3): 299-.doi: 10.3969/j.issn.1674-8115.2011.03.011

• 论著（临床研究） • 上一篇    下一篇

冠状动脉内与静脉内应用替罗非班对血小板聚集率的影响

宋 洁, 仇兴标, 叶 颖, 侯旭敏, 施鸿毓, 方唯一   

  1. 上海交通大学附属胸科医院心内科, 上海 200030
  • 出版日期:2011-03-28 发布日期:2011-03-29
  • 作者简介:宋 洁（1984—）, 女, 住院医师, 硕士；电子信箱: love.clean@163.com。

Effects of intracoronary and intravenous application of tirofiban on platelet aggregation rate

SONG Jie, QIU Xing-biao, YE Ying, HOU Xu-min, SHI Hong-yu, FANG Wei-yi   

  1. Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai 200030, China
  • Online:2011-03-28 Published:2011-03-29

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摘要：

目的 比较冠状动脉内与静脉应用替罗非班对急性冠状动脉综合征（ACS）患者冠状动脉和静脉内血小板聚集率（PAR）的影响。方法 18例拟行经皮冠状动脉介入术（PCI）治疗的ACS患者随机分为替罗非班冠状动脉内应用组（IC组，n=9）和替罗非班静脉内应用组（IV组，n=9）。分析给药后不同时间点PAR在组内的变化及PAR降低幅度在组间的差异，记录两组患者出血事件和血小板减少症的发生情况。结果 两组患者给药后PAR均得到抑制，与给药前比较差异有统计学意义（P＜0.05）。在冠状动脉血样中，IC组较IV组的PAR降低趋势更明显（P=0.062）；在外周静脉血样中，两组PAR的降低幅度相似，差异无统计学意义（P>0.05）。两组患者出血事件和血小板减少症的发生率比较差异无统计学意义（P>0.05）。结论 冠状动脉内或静脉内应用替罗非班均能快速有效地降低冠状动脉局部及静脉内的PAR，且不增加出血风险。

关键词: 急性冠状动脉综合征, 经皮冠状动脉介入术, 替罗非班, 血小板聚集, 冠状动脉内, 静脉

Abstract:

Objective To investigate the effects of intracoronary and intravenous application of tirofiban on platelet aggregation rate (PAR) in patients with acute coronary syndrome (ACS). Methods Eighteen patients with ACS undergoing percutaneous coronary intervention(PCI) were randomized into intracoronary tirofiban bolus group (group IC, n=9) and intravenous tirofiban bolus group (group IV, n=9). The changes of PAR at different time points after tirofiban application in two groups and the differences in the degree of PAR decrease between two groups were analysed, and the prevalences of bleeding and thrombocytopenia were also recorded. Results PAR decreased after treatment with tirofiban in both groups, and there were significant differences between PAR after treatment and that before treatment (P＜0.05). In coronary artery, the trend of PAR decrease in group IC was more significant than that in group IV (P=0.062). In peripheral vessel, there was no significant difference in the degree of PAR decrease between two groups (P＞0.05). There was no significant difference in the prevalences of bleeding and thrombocytopenia between two groups (P＞0.05). Conclusion Both intracoronary and intravenous application of tirofiban can effectively decrease PAR in coronary artery and peripheral vessel, and may not increase the risk of bleeding.

Key words: acute coronary syndrome, percutaneous coronary intervention, tirofiban, platelet aggregation, intracoronary, intravenous