国产替罗非班在急性冠脉综合征介入治疗中应用的安全性及长期疗效观察  

Safety and Long-term Efficacy of Tirofiban in Interventional Treatment of Patients with Acute Coronary Syndrome

作　　者：张孝忠[1,2] 张军[1,2] 王红[1,2] 张晋[1,2] 蒋静[1,2] 

机构地区：[1]军事医学科学院心脏病介入诊疗中心 [2]中国人民解放军307医院心内科,北京市100071

出　　处：《中国全科医学》2010年第5期535-536,共2页Chinese General Practice

摘　　要：目的观察国产替罗非班在急性冠脉综合征(ACS)介入治疗中应用的长期疗效。方法共入选123例ACS患者,其中男69例,女54例,均符合冠脉介入治疗适应证并成功进行了冠脉血运重建。替罗非班按0.4μg.kg-1.min-1静脉滴注,30 min后改为0.1μg.kg-1.min-1,连续静脉滴注24～48 h。术后肝素或低分子肝素减为半量,阿司匹林及氯吡格雷按ACS的常规剂量使用。观察用药后30 d及1年内任何原因的死亡、新的心肌梗死及顽固性心绞痛的发生情况。结果30 d内因颅内出血死亡1例(0.8%),无新的心肌梗死及顽固性心绞痛发生。随访1年内无死亡、新的心肌梗死发生,发生心绞痛2例(1.6%)。发生轻中度出血15例(12.2%),严重出血2例(1.6%)。结论国产替罗非班是一种选择性高、抗血小板疗效好、安全性高的药物,长期随访疗效肯定,适合ACS患者应用。Objective To observe long-term efficacy of Tirofiban in interventional treatment of patients with Acute Coronary Syndrome（ACS）.Methods One hundred twenty-three ACS patients（69 males,54 females）,who were in line with the current coronary interventional treatment indications and received coronary revascularization successfully,were enrolled and first given intravenous drip of domestic tirofiban in a dose of 0.4 μg·kg^-1.min^-1or 30 min,and then in a dose of 0.1 μg·kg^-1.min^-1ontinuously for 24 h^48 h.Heparin or low-molecular-weight heparin was reduced by half,and aspirin and clopidogrel were given in conventional dose.Death for any reason,new myocardial infarction and refractory angina pectoris were observed within 30 days or 1 year after use of tirofiban.Results Within 30 days of medication,1 patient died of intracranial hemorrhage（0.8%）,no more myocardial infarction and refractory angina pectoris occurred.After a 1-year follow up,no more deaths or myocardial infarctions were noted,but angina pectoris appeared in 2 patents（1.6%）;15 presented with mild-moderate bleeding（12.2%）,2 with severe bleeding.Conclusion Tirofiban,a safer drug with high selectivity and good anti-platelet effectiveness,is fit for ACS patients.

关 键 词：盐酸替罗非班 急性冠脉综合征 冠脉介入治疗 长期疗效 

分 类 号：R542[医药卫生—心血管疾病]