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目的:探讨接受早期介入治疗的高危急性冠脉综合征(ACS)患者,血小板膜糖蛋白(GP)Ⅱb/Ⅲa受体拮抗剂的最佳应用时机。方法:选择接受早期冠脉介入治疗(PCI)的高危不稳定型心绞痛/非ST段抬高心肌梗死(UA/NSTEMI)患者162例,按替罗非班使用时机分常规早期治疗组和延期选择性治疗组,分别评估两种治疗方案对PCI术前、术后心肌组织水平灌注和30天复合心血管事件发生率的影响。结果:PCI术前TMPG分级0～1级患者共65例(40.1%),其中早期治疗组27例(32.9%),延期治疗组38例(47.5%);统计显示早期治疗组PCI术前TMPG分级0～1级发生率显著低于延期治疗组(P<0.05)。30天复合心血管事件及出血发生率两组无差异(P>0.05)。结论:GPⅡb/Ⅲa拮抗剂早期治疗能改善PCI术前心肌微循环,提高组织水平灌注。
Objective: To investigate the optimal timing of platelet glycoprotein (GP Ⅱb / Ⅲa) receptor antagonists in patients with high-risk acute coronary syndrome (ACS) undergoing early intervention. Methods: Totally 162 high-risk patients with unstable angina pectoris / non-ST-segment elevation myocardial infarction (UA / NSTEMI) receiving early coronary intervention (PCI) Sex treatment group, respectively, to evaluate the two kinds of treatment options for PCI preoperative and postoperative myocardial perfusion and 30-day composite cardiovascular events. Results: There were 65 cases (40.1%) of TMPG grade 0 ~ 1 before PCI, including 27 cases (32.9%) in early treatment group and 38 cases (47.5%) in delayed treatment group. The statistics showed that TMPG The grade 0 ~ 1 grade was significantly lower than the delayed treatment group (P <0.05). 30-day composite cardiovascular events and the incidence of bleeding was no difference between the two groups (P> 0.05). Conclusion: Early treatment with GPⅡb / Ⅲa antagonist can improve myocardial microcirculation and improve tissue perfusion.