| Research background:In recent years, the incidence of acute coronary syndrome (Acute Coronary Syndrome, ACS) has been gradually more and more hazardous to human health, becomes the focus of attention.Currently through General cardiovascular doctor and clinical scholars of tireless efforts, clinical work in the on acute Crown pulse integrated levy of treatment made has major progress, by skin cavity within coronary intervention treatment (Percutaneous Coronary Intervention, PCI) has became cardiovascular internal medicine professional doctor for coronary heart disease patients for treatment and protection of important measures, especially in in recent years of strongly carried out, makes acute Crown pulse integrated levy of fatality rate, and again hospital rate has has obviously declined.Percutaneous transluminal coronary artery intervention therapy (Percutaneous Coronary Intervention, PCI) is in ACS patients can effectively discharge coronary artery in acute or chronic ischemia, prevent stent Restenosis, so effective in improving cardiac function and prognosis of patients with an effective way to effect.Induction and reperfusion injury mediated by several factors but no-reflow, slow flow, still is one of the major factors of cardiovascular events after PCI.For the specific non-peptide tirofiban is a Ⅱb/Ⅲa of platelet glycoprotein receptor (GPIIb/IIIa) antagonist, blocking platelet aggregation and activation ultimately means full inhibition of platelet aggregation, is expected to become the settlement of no-reflow phenomenon after PCI, sustained flow of thrombosis in hypercoagulable State an alternative to this problem..Purpose:1. Select College Admissions-October2010to October2012primary diagnosis prepared for the ACS patients undergoing elective PCI.Moves the selected Diagnostics prepared for the ACS patients undergoing elective PCI were randomly assigned to take non-Lo tracks and other than for the Romanian team.Records of two groups of patients by gender, age, smoking history, previous history of PCI or CABG, hypertension,diabetes, High blood cholesterol.2. For non-team Rowe hydrochloride in treatment of offenders within the vascular vein before (standard load-dose two-thirds), coronary (standard load-dose one-third) application standard loading dose tirofiban hydrochloride, and to maintain the standard-dose tirofiban hydrochloride24-36hour continuous point.Yu Tong in the control group.Observation of PCI related vascular lesions TIMI blood flow immediately after dyeing ratings, CK-MB, CTFC, myocardial reperfusion myocardial margin.3. On all data for statistics processing used statistics software SPSS13.0software package, with are number±standard poor said measurement information, used t test for measurement information two group between comparison, with rate said count information, used x2test or Fisher exact probability law for group between comparison, grade information and the non-are State measurement information line rank and test, has statistics meaning of numerical defined for P<0.05, has significantly sexual difference.Results:1.This study selected a total of142cases of patients with ACS,110cases of male patients, female patients in32cases.Their average age of60.23±years, two groups of patients by gender, age, smoking history, hypertension, diabetes, High blood cholesterol, previous history of PCI or CABG, drug use, and stent implantation in blood vessels, no statistically significant difference in the number of offenders (P>0.05).2.Two groups of patients undergoing elective PCI, culprit artery were successfully opened, no deaths.Tirofiban hydrochloride group where the culprit artery blood flow after coronary artery PCI TIMI grade3rate slightly higher than the control group, but no significant statistical differences between the two groups (92.7%vs.86.6%, P=0.262)。Tirofiban hydrochloride groups myocardial reperfusion myocardial dyeing rate of grade3level than no application of tirofiban hydrochloride group is slightly higher but statistically significant differences between the two groups is not clear (72.5%vs.64.3%,P>0.05) and application of tirofiban hydrochloride TIMI frame count of blood flow than the group without application of tirofiban hydrochloride group low (29.36±vs.37.48±11.94, P=0.003)。The ejection fraction of the heart, resulting in no statistically significant differences.Conclusion:1.Use normal platelet anticoagulant therapy in patients with ACS, based on combined intravenous application of tirofiban in the coronary, TIMI3flow rate in the two groups:applications for the non-team and did not apply for the non-tirofiban Group (92.7%vs.86.6%), variance (p>0.05);Comparison of two sets of corrected TIMI frame count:application for the non-team and did not apply for the non-tirofiban Group (37.48±vs.29.36±12.50,p=0.003), a statistically significant difference.Rates of two groups of myocardial perfusion of myocardial dyed grade level3:application for the non-team Rowe and has not applied for the non-team Rowe (72.5%vs.64.3%), the difference was not statistically significant (p>0.05).Tirofiban description to improve myocardial cells in patients with ischemia blood supply.2.Comparison of two groups of cardiac ejection fraction (48.91%±6.21%vs.47.22%±):no statistically significant difference (p>0.05).Tirofiban indicates that eventually will do to platelet aggregation by blocking the way, inhibiting platelet aggregation, and effectively improve coronary blood flow, improve the degree of myocardial perfusion levels, but the effect on cardiac function is not obvious.3.In short, for ACS patients undergoing PCI and intravenous application of tirofiban combined Coronary artery application of tirofiban, better prevention of no-reflow, slow-reflow phenomenon, better Imaging results are available, thus improving the infarct-related coronary artery blood flow, but for improving cardiac function is not obvious. |
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