摘要
Abstract
Objective:To investigate the effects of different doses of tirofiban on coronary blood flow and bleeding risk in patients with non-ST-segment elevation myocardial infarction(NSTEMI)undergoing early percutaneous coronary intervention(PCI),so as to provide a basis for optimization of clinical dosage.Methods:A total of 120 NSTEMI patients undergoing early PCI in the department of cardiology of a certain hospital from January 2023 to March 2025 were selected and randomly divided into low-dose group(group A,tirofiban loading dose 5 μg/kg,maintenance dose 0.075 μg/(kg·min),medium-dose group(group B,tirofiban loading dose 10 μg/kg,maintenance dose 0.1 μg/(kg·min)and high-dose group(group C,tirofiban loading dose 15 μg/kg,maintenance dose 0.125 μg/(kg·min)by random number table method,with 40 cases in each group.Immediate postoperative coronary blood flow indicators[thrombolysis in myocardial infarction(TIMI)grade,corrected TIMI frame count(CTFC)],bleeding risk[Bleeding Academic Research Consortium(BARC)grade],peak myocardial injury and heart function at 1 week after operation[cardiac troponin I(cTnI),creatine kinase isoenzyme(CK-MB),B-type natriuretic peptide(BNP),left ventricular ejection fraction(LVEF)]and 30-day after major adverse cardiovascular events(MACE)incidence were compared among the three groups.Results:Immediately after operation,the TIMI 3 grade rates in groups B and C(90.00％and 87.50％)were higher than that in group A(70.00％),and CTFC was lower than that in group A(P<0.05).The BARC grade 2 or higher bleeding rate in group C(25.00％)was higher than that in groups A and B(5.0％and 7.50％,P<0.05).The peak levels of cTnI,CK-MB and BNP in groups B and C were lower than those in group A,and LVEF at 1 week after operation was higher than that in group A(P<0.05).There was no significant difference in 30-day MACE incidence among the three groups(P>0.05).Conclusion:Both medium-dose and high-dose tirofiban can effectively improve coronary blood flow,reduce myocardial injury and improve cardiac function.However,high-dose tirofiban increases bleeding risk,while medium-dose tirofiban has controllable bleeding risk,which is a suitable dose with more balanced efficacy and safety.关键词
替罗非班/剂量/非ST段抬高型心肌梗死/早期经皮冠状动脉介入术/冠状动脉血流/出血风险Key words
tirofiban/dose/non-ST-segment elevation myocardial infarction/early percutaneous coronary intervention/coronary blood flow/bleeding risk分类
医药卫生
