Abstract：Objective To investigate the clinical efficacy of thrombus aspiration combined with tirofiban in emergency percutaneous coronary intervention (PCI) and its effect on the expression of inflammatory factors in patients. Methods Two hundred and twenty patients with acute myocardial infarction were divided into the study group and the control group. The control group was treated with thrombus aspiration combined with PCI while the study group was additionally given intravenous drip of tirofiban. TIMI blood flow grading changes were detected in both groups. The levels of CRP, IL-6, TNF-α, cTnI and BNP were detected in the two groups before and 24 hours after operation. Clinical outcome indexes of the two groups were observed: the incidence of immediate postoperative ST segment of electrocardiograms that decreased by more than 50%, postoperative LVEF, and Killip grade at discharge. Results The TIMI blood flow grade of the two groups improved significantly, especially in the control group. The difference was statistically significant (P＜0.05). 24 hours after operation, the levels of CRP, IL-6 and TNF- alpha of the two groups decreased significantly. The difference was statistically significant (P＜0.05). CRP(10.17±1.39)mg/L, IL-6(21.85±2.97)mg/L and TNF- alpha(41.35±4.70)ng/L in the study group were lower than those in the control group(11.64±1.73)mg/L,(25.01±3.27)mg/L,and 37.96±3.81)ng/L. 24 hours after operation, cTnI and BNP of the two groups were significantly reduced, especially in the study group. The difference was statistically significant (P＜0.05). The incidence of adverse cardiovascular events in the study group was lower than that in the control group. When the patients in the study group were discharged from hospital, the incidence of ST segment of electrocardiograms decreased by more than 50%(65.45%), while LVEF(56.39±5.13)and Killip grades were better than those in the control group(50.91%、46.72±4.05), the difference was statistically significant (P＜0.05). Conclusions Tirofiban can further reduce the secretion of inflammatory factors, alleviate myocardial injury and improve blood flow perfusion in emergency PCI patients.
刘博江, 王赟赟, 吴鹏, 赵越, 刘迎午. 急诊经皮冠状动脉介入治疗术中应用血栓抽吸联合替罗非班治疗对炎性反应因子的影响[J]. 武警医学, 2019, 30(4): 291-294.
LIU Bojiang, WANG Yunyun, WU Peng, ZHAO Yue, LIU Yingwu. Clinical efficacy of tirofiban combined with thrombus aspiration in emergency PCI patients and the influence on inflammatory factors. Med. J. Chin. Peop. Armed Poli. Forc., 2019, 30(4): 291-294.
Wang J L, Chen C C, Wang C Y, et al. Acute type a aortic dissection presenting as ST-Segment elevation myocardial infarction referred for primary percutaneous coronary intervention[J]. Acta Cardiol Sin,2016;32(3):265-272.
[6]
Zhang X L, Zhu Q Q, Yang J J, et al. Percutaneous intervention versus coronary artery bypass graft surgery in left main coronary artery stenosis: a systematic review and meta-analysis[J]. BMC Med,2017;15(1):84.
Li L, Ge Z, Zhang D, et al. Efficacy and safety of quadruple therapy including tirofiban in the treatment of Chinese NSTE-ACS patients failing to receive timely percutaneous coronary intervention[J]. Drug Des Devel Ther, 2017,11:3299-3307.
[15]
Lago I M, Novaes G C, Badran A V, et al. In-lab upfront use of tirofiban may reduce the occurrence of No-reflow during primary percutaneous coronary intervention[J]. Arq Bras Cardiol,2016;107(5):403-410.
2019, Vol. 30 
