非ST段抬高急性冠状动脉综合征患者早期介入治疗前应用替罗非班近期预后的临床观察  

Effect of tirofiban used before early PCI on recent prognosis in patients with non ST elevation acute coro-nary syndromes.

作　　者：芦涤[1] 郭乐凌[1] 周琪[1] 

机构地区：[1]天津医科大学附属石油医院心内科,河北省廊坊市065000

出　　处：《中国综合临床》2007年第10期865-867,共3页Clinical Medicine of China

摘　　要：目的观察非ST段抬高急性冠状动脉综合征(ACS)患者早期介入治疗前使用替罗非班的疗效。方法99例高危非ST段抬高ACS患者在进行12～48 h药物治疗后,随机分为观察组(48例)和对照组(51例),行早期冠状动脉介入治疗(PCI)。观察组于PCI前30～60 min加用替罗非班,比较2组的治疗效果。结果观察组PCI术后30 d复合心血管事件(心绞痛复发+再次心肌梗死+死亡)发生率明显低于对照组,分别为6.3%与23.5%(P<0.05);观察组术后血小板聚集率明显降低,疗效优于对照组(P<0.01);2组的主要不良反应为轻度出血,观察组有增加趋势,但与对照组比较差异无统计学意义(P>0.05)。结论非ST段抬高ACS早期介入治疗前使用替罗非班可改善患者的近期预后且不增加出血风险。Objective To observe the effectiveness of tirofiban used before early invasive strategy in patients with non-ST elevation acute coronary syndromes （ ACS ）. Methods Ninety-nine patients with non-ST elevation ACS who were at high risk were randomly divided into treatment group（ n =48 ） and control group（ n = 51 ） after medicine treatment for twelve to forty-eight hours. Then the patients received early percutaneous coronary intervention （PCI）. Tirofiban was used in the former group 30-60 minutes before operation. The clinical effects of the two groups were compared. Result The ineideuce of the composite primary end point at 30 days after PCI in the treatment group was lower than that of the control group（ 6.3% vs 23.5% P 〈 0.05 ）. The rate of platelet aggregation in the treatment group was much lower than that in the control group （ P 〈 0.01 ）. The primary complication in the two groups was slight bleeding. There was no significant difference between the two groups in occurrencc of bleeding（ P 〉 0.05 ）. Conclusion The prognosis of the patients with non ST elevation acute coronary syndromes is improved by using Tirofiban before PCI, but bleeding is not increased.

关 键 词：急性冠状动脉综合征 早期介入治疗 替罗非班 

分 类 号：R541.4[医药卫生—心血管疾病]