依替巴肽与替罗非班在ACS介入治疗中有效性和安全性  

Efficacy and safety of native eptifibatide and tirofiban in patients with acute coronary syndrome undergoing percutaneous coronary intervention

作　　者：唐建金[1] 王连生[1] 王晖[1] 王明伟[1] 杨志健[1] 曹克将[1] 

机构地区：[1]南京医科大学第一附属医院心脏病科,210029

出　　处：《江苏医药》2008年第10期989-992,共4页Jiangsu Medical Journal

摘　　要：目的探讨依替巴肽与替罗非班在急性冠状动脉综合征(ACS)介入治疗中的临床疗效和安全性。方法ACS中不稳定型心绞痛及非ST段抬高心肌梗死(UA/NSTEMI)28例,按就诊顺序随机分为依替巴肽(受试)组和替罗非班(对照)组,在常规予抗血小板及抗凝治疗基础上,经皮冠状动脉介入治疗(PCI)手术开始时即静脉予依替巴肽或替罗非班,观察比较两组住院期间及术后30 d主要不良心脏事件(MACE)、出血情况及血小板减少症。结果两组住院期间及术后30 d内MACE事件均未发生;24 h心电图缺血导联数与用药及PCI前相比均减少,对照组更明显(P<0.05);两组均未发生大出血事件,轻微出血发生率受试和对照分别为21.4%和28.6%。结论两种血小板膜糖蛋白受体拮抗剂在ACS介入治疗中均能起到辅助作用,且安全性好,但长期疗效及毒副作用有待进一步研究观察。Objective To compare the clinical outcomes and safety of eptifibatide and tirofiban in patients with acute coronary syndrome （ACS） undergoing percutaneous coronary intervention （PCI）. Methods Twenty-eight patients with ACS （UA / NSTEMI） underwent PCI were randomly divided into two groups of receiving eptifibatide or tirofiban treatment. Eptifibatide or tirofiban was predominantly initiated in the catheter laboratory before the intervention. Clinical features, in-hospital and 30-day MACE outcomes, bleeding and platelet counting were investigated in two groups. Results There were no in-hospital and 30-day MACE events in two groups. The number of the ischemia leads after treatment reduced compared to that before in both groups. There was a better improvement in the number of 24-h ischemia leads after administration in tirofiban group than that in eptifibatide group （4. 21 ± 2.22 vs. 4.00± 3.21, P〈0. 05）. The two groups had no incidence of massive bleeding. Minor bleeding rates of eptifibatide group and tirofiban group were 21.4% and 28.6%, respectively. Conclusion Eptifibatide as an adjuvant to PCI may further decrease the incidence of ischemia events in patients with ACS and improve the safety, but its long-term efficacy and side effects need to be observed further.

关 键 词：依替巴肽 替罗非班 急性冠状动脉综合征 经皮经腔冠状动脉血管成形术 血小板膜糖蛋白受体拮抗剂 

分 类 号：R617[医药卫生—外科学]