行PCI术中冠脉内应用替罗非班对急性心肌梗死患者血清hs-CRP及sCD40L影响.docVIP

行PCI术中冠脉内应用替罗非班对急性心肌梗死患者血清hs-CRP及sCD40L影响【摘要】 目的 探讨行经皮冠状动脉介入治疗(PCI)术中冠脉内应用替罗非班对急性心肌梗死患者血清超敏C反应蛋白(hs-CRP)和可溶性CD40配体(sCD40L)的影响。 方法 行PCI手术的82例急性心肌梗死患者随机分为两组，对照组40例，治疗组42例；对照组采用常规治疗，治疗组在行PCI术中冠脉内注射替罗非班。观察PCI术后的血流，血清hs-CRP和sCD40L。 结果 梗死相关冠脉血流(TIMI)达到3级的对照组33例，治疗组40例，两组有统计学差异( P 0.05)。两组在治疗后均明显改善了患者血清hs-CRP和sCD40L，并且治疗组改善更加明显( P 0.05)，具有统计学意义。 结论 PCI术中冠脉内使用替罗非班可以明显改善急性心肌梗死患者的血流，减少血清hs-CRP和sCD40L的表达。 【关键词】 经皮冠状动脉介入治疗；替罗非班；超敏C反应蛋白；可溶性CD40配体  The effectiveness of intracoronary injection of tirofiban on hs-CRP and sCD40L on patients with acute myocardial infarction LI Lai-shi. Xinwen mining group, the cardiology of laiwu center hospital,Shandong 271103,China  【Abstract】 Objective To study the effectiveness of intracoronary injection of tirofiban on high sensitivity C-reactive protein (hs-CRP) and soluble CD40 ligand (sCD40L) on patients with acute myocardial infarction. Methods Eighty-two patients with acute myocardial infarction through percutaneous coronary intervention(PCI) were randomly divided into two groups,the control group(n=40 cases) and the treatment group(n=42 cases).The patients in the control group were treated through the conventional treatment and the patients in the treatment group were treated through intracoronary injection of tirofiban.The thrombolysis in myocardial infarction(TIMI),hs-CRP and sCD40L were compared. Results The patients whose TIMI was more than three class were 33 cases in the control group and 40 cases in the treatment group.There was a significant difference( P 0.05). The hs-CRP and sCD40L in the serum were all lowed after treatment in both groups. The hs-CRP and sCD40L in the treatment were improved significantly more than those of the control group( P 0.05). Conclusion Intracoronary injection of tirofiban through PCI can improve thrombolysis,descrease hs-CRP and sCD40L. 【Key words】 Percutaneous coronary intervention; Tirofiban;hs-CRP; sCD40L 目前STEMI 首选的再灌注治疗策略是直接经皮冠状动脉介入治疗(PCI)。但是，在进行PCI后观察仍有10％～30％的患者心