摘要
目的:评价血小板糖蛋白Ⅱb/Ⅲa受体抑制剂替罗非班用于急性非ST段抬高心肌梗死(NSTEMI)患者介入治疗中近期的安全性和有效性。方法:2005年9月至2007年1月我科收治的拟行经皮冠状动脉介入治疗(PCI)的NSTEMI患者114例,随机分为替罗非班组(57例)及对照组(57例),所有患者PCI术前均常规联合应用阿司匹林、氯吡格雷和低分子肝素。比较两组用药后24 h和30 d的复合缺血事件的发生率,以及用药后48 h和30 d的出血和可逆性血小板减少症等并发症发生率。结果:PCI后24 h内:对照组1例(1.8%)再发心绞痛,2例(3.6%)发生急性血栓;替罗非班组无上述事件发生。术后30 d:对照组2倒(3.6%)、替罗非班组1例(1.8%)再发心绞痛;对照组2例(3.6%)发生亚急性血栓,替罗非班组无亚急性血栓发生。住院期间对照组及替罗非班组均有1例(1.8%)发生了上消化道出血。两组30 d内均无死亡、无皮肤黏膜出血、无颅内出血及血小板减少等并发症发生。24 h和30 d的复合缺血事件的发生率两组比较,差异均有显著性(均P<0.05)。出血和可逆性血小板减少症等并发症发生率两组比较无显著性差异。结论:PCI术后在常规治疗基础上加用替罗非班,能降低近期心血管事件的发生,出血事件及血小板减少较对照组无显著增加,证明其在早期冠心病介入治疗中使用安全而有效。
Objective： To evaluate the efficacy and safety of tirofiban, a platelet glycoprotein Ⅱb/Ⅲ a Inhibitor, in percutaneous coronary intervention （PCI） of patients with acute non-ST segment elevation myocardial infarct （NSTEMI） . Methods： A total of 114 patients with acute NSTEMI were enrolled in the trial from Sep. 2005 to Jan. 2007; they were randomly divided into 2 groups： tirofiban group （n =57） and placebo group （n= 57）. Patients in tirofiban group were given tirofiban for 24 h after PCI. All patients were routinely given heparin, aspirin and elopidogrel before CPI. The composite occurrence of death, myocardial infarction （MI）, need for target vessel revascularization （TVR） after PCI, and the adverse effects （hemorrhage and thrombocypenia） were compared between the 2 groups. Results; One （ 1.8% ） patient had angina peetoris and the other （ 1. 8% ） developed subaeute thrombus in control group within 24 h after PCI： there was no such event in the tirofiban group. Two （3.6%） patients developed angina peetoris and 2 （3. 6%） developed subacute thrombus within 30 days after PCI in control group; one patient （1. 8%） in birofiban group developed angina pectoris and one patient in birofiban group developed subacute thrombus. Each group had one case （1. 8%） of upper digestive tract bleeding during hospitalization. No intraeranial hemorrhage, skin/ mueosa hemorrhage, thromboeytopenia, or,death occurred in the 2 groups. Intravenous tirofiban treatment reduced the composite occurrence of death of NSTEMI patients after PCI （P〈0, 05）. There was no significant difference in occurrence of complications such as intracranial hemorrhage, skin/mucosa hemorrhage, or thrombocytopenia between the 2 groups. Conclusion; Intravenous tirofiban treatment after PCI can reduce the composite occurrence of death, MI, and need for TVR without increasing the adverse reactions of the drugs; it is safe and effective in patients undergoing early coronary stenting.
出处
《第二军医大学学报》
CAS
CSCD
北大核心
2007年第5期524-526,共3页
Academic Journal of Second Military Medical University
作者简介
李南,主治医师.E-mail：z80z@tom.com
