替罗非班联合尿激酶原对ACS患者PCI术后血流灌注及预后的影响

摘要/Abstract

摘要： 目的探究冠脉内注射替罗非班（tirofiban,TIR）联合尿激酶原（prourokinase,Pro-UK）对急性冠状动脉综合征（acute coronary syndrome,ACS）患者经皮冠状动脉介入治疗（percutaneous coronary intervention,PCI）术后心肌血流灌注及近期预后的影响。方法选取2021年5月至2023年12月在本院行PCI的400例ACS患者作为研究对象,采用电脑随机派位抽签法分为TIR组（行PCI期间于冠脉内注射TIR,n=200）和Pro-UK联合TIR组（行PCI期间于冠脉内注射Pro-UK联合TIR,n=200）。比较两组用药后效果、PCI术前后溶栓治疗心肌梗死血流分级（thrombolysis in myocardial infarction flow grade,TIMI）、TIMI心肌灌注分级（TIMI myocardial perfusion grade,TMPG）及心功能情况,并记录PCI术后1周不良反应发生情况。结果 Pro-UK联合TIR组CTFC低于TIR组[（20.36±6.09）帧 vs（24.25±8.17）帧,P<0.05],NRP发生率更低（5.00% vs 14.00%,P<0.05）,STR≥50%比例更高（89.00% vs 77.00%,P<0.05）。PCI术后,两组TIMI 3级比例分别为88.00%和78.00%,TMPG 3级比例分别为92.00%和80.00%,差异均有统计学意义（P<0.05）。PCI术后心功能指标LVEF、LVEDD、LVESD在两组间比较差异无统计学意义（P>0.05）。PCI术后1周,不良反应总发生率Pro-UK联合TIR组低于TIR组（4.50% vs 13.00%,P<0.05）。结论冠脉内注射Pro-UK联合TIR可显著削减ACS患者PCI术后不良反应发生风险,对心肌血流灌注起明显改善作用,不影响心功能,总体效用良好,安全性高,具推广应用价值。

关键词: 替罗非班, 尿激酶原, 急性冠状动脉综合征, 冠状动脉介入术, 心肌血流灌注, 近期预后

王芳芳, 靳朝辉, 赵洋. 替罗非班联合尿激酶原对ACS患者PCI术后血流灌注及预后的影响[J]. 心血管病防治知识, 2025, 15(22): 3-7.

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