盐酸替罗非班对急性STEMI患者内皮功能的影响
《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]
- 期数:
- 2015年第5期
- 页码:
- 553-555,564
- 栏目:
- 临床研究
- 出版日期:
- 2015-05-05
文章信息/Info
- Title:
- Effect of tirofiban hydrochloride on endothelial function in patients with acute ST segment elevation myocardial infarction
- Author(s):
- LONG Pan; ZHANG Tian-tian; XIE Qian-qian; WANG Jin; ZHOU Jun; ZHANG Jun-feng
- (Department of Cardiology, No.3 People’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 201999, China)
- Keywords:
- myocardial infarction; ST segment elevation; platelet glycoprotein IIb/IIIa inhibitor; tirofiban hydrochloride; endothelial microparticle; percutaneous transluminal coronary interventions
- 分类号:
- R541.4
- DOI:
- -
- 文献标识码:
- A
- 摘要:
- 目的 探讨血小板糖蛋白Ⅱb/Ⅲa受体拮抗剂（glycoprotein Ⅱb/Ⅲa inhibitor，GPI)盐酸替罗非班对急性ST段抬高型心肌梗死(ST segment elevation myocardial infarction,STEMI)患者内皮功能的影响。方法 根据术前是否使用盐酸替罗非班，将100例于我院行急诊经皮冠状动脉介入(percutaneous transluminal coronary interventions,PCI)术的STEMI患者分为试药组（73例）和对照组（27例）。应用流式微球技术检测各组手术前后血浆内皮微粒（endothelial microparticles，EMP）表达变化；应用酶联免疫吸附试验（ELISA）检测血清细胞间黏附分子（intercellular adhesion molecule,ICAM）-1、内皮素（endothelin,ET）-1表达变化。结果 术前试药组EMP、ICAM-1、ET-1表达与对照组相比无统计学差异；与术前相比，试药组术后EMP、ICAM-1、ET-1表达无明显变化，对照组术后EMP、ICAM-1、ET-1表达升高。结论 盐酸替罗非班可抑制STEMI患者PCI术后EMP、ICAM-1、ET-1的上升，可能与改善内皮功能有关。
- Abstract:
- AIM This study aimed to investigate the influence of platelet glycoprotein IIb/IIIa inhibitor (GPI) tirofiban hydrochloride on endothelial function of ST segment elevation myocardial infarction (STEMI) patients. METHODS 100 STEMI patients who underwent emergency PCI in our hospitial were divided into the experimental drug group (n=73) and control group (n=27) according to whether tirofiban hydrochloride was used before PCI. Endothelial microparticle (EMP) expression was determined with cytometric bead array, whereas intercellular cell adhesion molecule-1 (ICAM-1) and endothelin-1 (ET-1) with ELISA before and after PCI in both groups. RESULTS 1) There was no significant difference of EMP, ICAM-1 and ET-1 levels in the drug experimental group and the control group before PCI. 2) There was no statistically significant difference of EMP, ICAM-1 and ET-1 levels in the drug experimental group before and after PCI. EMP level after PCI in the control group was higher than that before PCI, with statistical difference (P<0.05). ICAM-1 and ET-1 levels after PCI in the control group were significantly higher than those before PCI (P<0.01). CONCLUSION Tirofiban hydrochloride was able to inhibit the increase of EMP, ICAM-1 and ET-1 in the serum of STEMI patients after PCI, which was related to improvement of endothelial function.
参考文献/References
[1]Winchester DE,Wen X,Brearley WD,et al.Efficacy and safety of glycoprotein IIb/IIIa inhibitors during elective coronary revascularization: a meta-analysis of randomized trials performed in the era of stents and thienopyridines[J].J Am Coll Cardiol,2011,57(10):1190-1199.
[2]Rezkalla SH,Kloner RA.Coronary no-reflow phenomenon:from the experimental laboratory to the cardiac catheterization laboratory[J].Catheter Cardiovasc Interv,2008,72(7):950-957.
[3]张红雨,王佩显,曹艳君,等.冠状动脉内注射替罗非班对急性心肌梗死患者介入治疗中无复流现象的疗效研究[J].临床心血管病杂志,2011,27 (1):25- 29.
[4]Chironi GN,Boulanger CM,Simon A,el al.Endothelial microparticles in diseases[J].Cell Tissue Res,2009,335(1):143-151.
[5]Werner N,Wassmann S,Ahlers P,et al.Circulating CD31+/annexin V+apoptotic microparticles correlate with coronary endothelial function in patients with coronary artery disease[J].Arterioscler Thromb Vasc Biol,2006,26(1):112-116.
[6]Nozaki T,Sugiyarna S,Koga H,et al.Significance of a multiple biomarkers strategy including endothelial dysfunction to improve risk stratification for cardiovascular events in patients at high risk for coronary heart disease[J].J Am Coil Cardiol,2009,54(7)：601-608.
[7]Albert M A,Glynn RJ,Bufing JE,et al.Differential effect of soluble intercellular adhesion molecIlle-l on the progression of athero-sclerosis as compared to arterial thrombosis：a prospective analysis of the Women’S Health Study[J].Atherosclerosis,2008,97(1):297-302.
[8]Han B,Ghanim D,Peleg A,et al.Loss of systemic endothelial function post-PCI[J].Acute Card Care,2008,10(2):79-87.
[9]Porto I,Biasucci LM,De Maria GL,et al.Intracoronary microparticles and microvascular obstruction in patients with ST elevation myocardial infarction undergoing primary percutaneous intervention[J].Eur Heart J,2012,33(23):2928-2938.
[10]Starnes HB,Patel AA,Stouffer GA.Optimal use of platelet glycoprotein IIb/IIIa receptor antagonists in patients undergoing percutaneous coronary interventions[J].Drugs,2011,71(15):2009-2030.
[11]De Luca G,Navarese EP,Cassetti E,et al.Meta-analysis of randomized trials of glycoprotein IIb/IIIa inhibitors in high-risk acute coronary syndromes patients undergoing invasive strategy[J].Am J Cardiol,2011,107(2):198-203.
[12]Porto I,De Maria GL,Di Vito L,et al.Microparticles in health and disease: small mediators, large role?[J].Curr Vasc Pharmacol,2011,9(4):490-500.
[13]Schmitt-Sody M,Metz P,Gottschalk O,et al.Selective inhibition of platelets by the GPIIb/IIIa receptor antagonist Tirofiban reduces leukocyte-endothelial cell interaction in murine antigen-induced arthritis[J].Inflarmn Res,2007,56(10):414-420.
[14]Salanova B,Choi M,Rolle S,el al.Beta2-integrins and acquired glycoprotein IIb/IIIa(GPIIb/IIIa)receptors cooperate in NF-kappaB activation of human neutrophils[J].J Biol Chem,2007,282(38):27960-27969.
备注/Memo
- 备注/Memo:
- 收稿日期：2014-10-22.
基金项目：上海申康市级医院技术推广项目资助（SHDC12012210）；上海市宝山区科委项目资助（12-E-63）
通讯作者：张俊峰，主任医师，主要从事冠心病综合防治研究 Email:jfzhang_dr@163.com
作者简介：龙盼，主治医师，硕士 Email：tian00han@sina.com
常用功能
统计/Statistics
- 摘要浏览/Viewed820
- 评论/Comments
