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目的:探讨替罗非班对经皮冠状动脉介入治疗(PCI)后支架内血栓形成的影响。方法:27例支架内血栓形成患者中,观察组(14例)均首先接受盐酸替罗非班10μg/kg 3 min静脉推注,继以0.15μg.kg-1.min-1持续点滴,之后行急诊PCI或继续静脉点滴72 h。对照组(13例)直接再次行急诊PCI。结果:观察组中死亡2例(14.3%),对照组中死亡3例(23.1%),2组比较,P>0.05;观察组中7例(50%)ST段回落,对照组中无一例ST段回落,2组比较,P<0.05;观察组中胸痛部分或全部缓解者7例(50%),无缓解者7例(50%),对照组中14例患者胸痛均无缓解,2组比较,P<0.05;TIMI血流2~3级者,观察组、对照组分别为5例、0例,2组比较,P<0.05。2组患者均未出现严重出血;观察组轻、中度出血发生率多于对照组(P<0.05)。结论:静脉推注大剂量替罗非班能减少急性或亚急性支架内的血栓量,化解清除部分或全部支架内的血栓,为再次急诊PCI争取时间。
Objective: To investigate the effect of tirofiban on stent thrombosis after percutaneous coronary intervention (PCI). Methods: In 27 patients with stent thrombosis, the observation group (14 patients) received intravenous infusion of tirofiban 10 μg / kg for 3 min followed by 0.15 μg.kg-1.min-1 Emergency PCI or continue intravenous drip 72 h. The control group (n = 13) underwent emergency PCI again. Results: In the observation group, there were 2 deaths (14.3%) in the observation group and 3 deaths (23.1%) in the control group, P> 0.05 in the two groups; in the observation group, 7 cases (P <0.05); 7 patients (50%) had chest pain partial or complete remission in observation group, 7 patients (50%) had no remission, and 14 patients in control group had no relief of chest pain.2 P <0.05; the TIMI blood flow grade 2 to 3, the observation group and the control group were 5 cases, 0 cases, 2 groups, no significant bleeding in the P <0.05.2 group; the observation group was mild, The incidence of moderate bleeding more than the control group (P <0.05). Conclusions: Intravenous bolus injection of tirofiban can reduce the amount of thrombus in acute or subacute stents and resolve some or all of thrombosis in stents, so as to gain time for emergency PCI.