摘要目的:探讨替罗非班联合高压氧(HBO)治疗对急性冠状动脉综合征(ACS)患者经皮冠状动脉介入(PCI)术后无复流的影响。方法:选取2015年1月至2020年1月在龙口市人民医院心内科治疗的ACS PCI术后无复流患者121例作为研究对象。所有患者按照治疗方法分为A、B、C组。A组患者40例，予以低分子肝素、阿司匹林及地尔硫卓等常规对症治疗。B组患者42例，在A组治疗的基础上予以替罗非班治疗；C组39例，在B组治疗的基础上给予HBO治疗。观察3组患者治疗前后心电图、血小板聚集率及主要终点事件的发生情况。采用散射比浊法检测高敏C反应蛋白(hs-CRP)含量，采用放射免疫分析法测定血清内皮素-1(ET-1)水平，采用酶联免疫吸附法测定血浆髓过氧化物酶(MPO)水平。结果:治疗2个疗程后，C组患者ST段压低、ST段抬高及缺血损伤导联数明显低于B组，B组患者ST段压低、ST段抬高及缺血损伤导联数明显低于A组，差异均有统计学意义( P<0.05)。C组患者治疗后主要终点事件发生率(7.7%)明显低于B组(19.0%)，B组患者治疗后主要终点事件发生率(19.0%)明显低于A组(40.0%)，差异均有统计学意义( P<0.05)。C组患者血小板聚集率明显低于B组，B组患者血小板聚集率明显低于A组，差异均有统计学意义( P<0.05)。C组患者血清hs-CRP、ET-1及血浆MPO水平明显低于B组，B组患者血清hs-CRP、ET-1及血浆MPO水平明显低于A组，差异均有统计学意义( P<0.05)。 结论:HBO联合替罗非班治疗ACS患者PCI术后无复流临床疗效明显，其主要是通过降低机体血液炎性因子及血小板聚集率实现的，值得临床推广应用。

abstractsObjective:To investigate the effect of tirofiban combined with hyperbaric oxygen (HBO) on no reflow after percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS).Methods:A total of 121 ACS patients with no reflow after PCI treated in the Department of Cardiology of Longkou People′s Hospital from January 2015 to January 2020, were selected as the study objects and divided into the A, B, and C groups according to the treatment. The group A with 40 patients were treated with low molecular weight heparin, aspirin, diltiazem, and other routine symptomatic treatments. The group B with 42 patients were treated with tirofiban hydrochloride on the basis of the treatment of the group A. The group C with 39 patients were treated with HBO on the basis of the treatment of the group B. The ECG, platelet aggregation rate, and the primary end point events were observed before and after treatment. The content of highly sensitive C-reactive protein (hs-CRP) was measured by nephelometry, the level of serum endothelin-1 (ET-1) was measured by radioimmunoassay, and the level of plasma myeloperoxidase (MPO) was measured by enzyme-linked immunosorbent assay.Results:After two courses of treatment, the numbers of ST segment depression, ST segment elevation, and ischemic injury leads in the group C were significantly lesser than those in the group B, and the numbers of ST segment depression, ST segment elevation, and ischemic injury leads in the group B were significantly less than those in the group A. All differences were statistically significant ( P<0.05). The incidence of primary endpoint events in the group C (7.7%) was significantly lower than that in the group B (19.0%), and the incidence of primary endpoint events in the group B (19.0%) was significantly lower than that in the group A (40.0%). All differences were statistically significant ( P<0.05). The platelet aggregation rate of the group C was significantly lower than that of the group B, and that of the group B was significantly lower than that of the group A ( P<0.05). The levels of serum hs-CRP, ET-1, and plasma MPO in the group C were significantly lower than those in the group B, and the levels of serum hs-CRP, ET-1, and plasma MPO in the group B were significantly lower than those in the group A ( P<0.05). Conclusion:HBO combined with tirofiban can achieve a significant therapeutic effect in the treatment of ACS patients with no reflow after PCI through reducing the inflammatory factors and platelet aggregation rate of the body, which is worthy of popularization and application in clinic.