急性心肌梗死急诊介入治疗中替罗非班对冠状动脉内皮细胞功能的影响

山东大学学报(医学版)

急性心肌梗死急诊介入治疗中替罗非班对冠状动脉内皮细胞功能的影响

李媛媛，来庆友，商德亚，刘东兴

山东大学附属省立医院急诊科，济南 250021

收稿日期:2007-11-05 修回日期:1900-01-01 出版日期:2008-05-16 发布日期:2008-05-16
通讯作者: 来庆友

Effects of Tirofiban on endothelial function in patients with acute myocardial infarction treated by primary percutaneous coronary intervention

LI Yuan-yuan, LAI Qing-you, SHANG De-ya, LIU Dong-xing

Department of Emergency, Provincial Hospital Affiliated to Shandong University, Jinan 250021, China

Received:2007-11-05 Revised:1900-01-01 Online:2008-05-16 Published:2008-05-16
Contact: LAI Qing-you

摘要/Abstract

摘要： 目的分析冠状动脉介入(PCI)治疗急性ST段抬高型心肌梗死(SEMI)中应用替罗非班对冠状动脉内皮细胞功能的影响。方法PCI治疗的急性STEMI患者117例，分为实验组60例，术前给予替罗非班10μg/kg静脉3min内推注，随后以0.15μg/(kg·min)持续泵入36h；对照组57例，未给予替罗非班。手术结束前取冠状静脉窦血检测血管性血友病因子(vWF)水平、组织因子(TF)及内皮细胞凋亡数；围术期检测外周静脉血黏附分子sICAM-1和sVCAM-1含量；比较两组患者近期临床疗效。结果与对照组比较，实验组vWF、TF水平显著降低(P＜0.05)，内皮细胞凋亡数明显减少(P＜0.05)，sICAM-1、sVCAM-1浓度降低(P＜0.05)。实验组术后住院期间难治性心绞痛、心肌再梗死及心力衰竭、30d心肌再梗死及心力衰竭发生率降低(P＜0.05)。结论替罗非班在急性心肌梗死急诊PCI治疗中可保护冠脉内皮细胞功能，提高近期临床疗效。

关键词: 冠状动脉介入, 内皮细胞, 心肌梗死, 替罗非班

Abstract: To investigate the effects of Tirofiban on endothelial cell function in patients with st-segment elevation myocardial infarction (STEMI) treated by primary percutaneous coronary intervention. MethodsOne hundred and seventeen patients with primary STEMI who underwent primary PCI were divided into two groups. Sixty patients in the experimental group were treated with Tirofiban, and fifty-seven patients in the control group were treated routinely without Tirofiban. Endothelial cell apoptosis, blood coagulation factor (TF and vWF), and concentration of the cellular adhesion molecules were determined, and the clinical outcomes in the near future were compared. Results Compared with the control group, concentration of the endothelial cell apoptosis, blood coagulation factor, and cellular adhesion molecules were lower in the experimental group (P＜0.05). Incidences of re-infarction and heart failure in the hospital as well as after 30 days were much less in the experimental group compared with the control group(P＜0.05). Conclusions Tirofiban could protect coronary artery endothelial function in patients with STEMI treated by percutaneous coronary intervention, and thereby improves the patient′s clinical outcome in the near future.

Key words: Tirofiban, Myocardial infarction, Percutaneous coronary intervention, Endothelial cell

中图分类号:

R541.4

李媛媛,来庆友,商德亚,刘东兴. 急性心肌梗死急诊介入治疗中替罗非班对冠状动脉内皮细胞功能的影响[J]. 山东大学学报(医学版), 2008, 46(5): 494-497.

LI Yuan-yuan,LAI Qing-you,SHANG De-ya,LIU Dong-xing. Effects of Tirofiban on endothelial function in patients with acute myocardial infarction treated by primary percutaneous coronary intervention[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2008, 46(5): 494-497.

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