The Effect Of GP Inhibitors And α-adrenergic Blocking Agents On The No-reflow Phenomenon During PCI

Objective: To observe the therapeutic effect on no-reflow (NR) phenomena of platelet glycoprotein receptor antagonist tirofiban administration or combined with α-adrenergic block agents urapidil to the patients with acute myocardial infarction during percutaneous coronary intervention (PCI).Methods: A total of40patients who had no-reflow during PCI were randomly divided to two group treatment group in which20cases were administated with tirofiban and urapidil, control group in which20cases were administered with tirofiban only. The crime coronary artery blood flow of the two groups were determind the factors of TIMI, CTFC and TMBG before and after the drug treatment, and it was also compared that the electrocardiogram, myocardial injury markers, cardiac function index, the incidence of cardiovascular events and complications. Finally, the serum factors related to endothelial function and inflammation were tested in two groups.Results1. acording to TIMI classification and TMBG grading, coadministation of tirofiban and urapidil improved the blood flow of the target blood vessels, reduced CTFC count when compared with the tirofiban injection group (P<0.05).2. The electrocardiogram and left ventricular function obviously restored and the CK-MB and cTnI decreased in treatment group when compared with control group,(P <0.05) there was no obvious difference between two groups in cardiovascular events and severe complications (P>0.05).3. the serum NO increased and lower the endothelin1, hs-CRP and NT-proBNP increased in coadministration group when compared with the tirofiban injection group (P <0.05).Conclusion1. The coadministration of tirofiban and urapidil during PCI can improve the blood flow of target blood vessels, alleviate the damage of the cardial tissue of the patient with myocardial infarction than that the single urapidil injection does, and the treatment effect of platelet membrane protein inhibitors combined with α blockers is better than that of single administation of platelet membrane protein inhibitors.2. The coadministration of tirofiban and urapidil play an important role on the protection endothelial cell, the inhibition of inflammatory reaction due to its inhibiting the serum factor related to endothelial function and inflammatory mediator.