替罗非班治疗不稳定型心绞痛49例疗效观察  

CLINICAL OBSERVATION ON THE EFFECTS OF 49 CASES UNSTABLE ANGINA TREAT WITH TIROFIBAN

作　　者：张英丽[1] 赵金玲[1] 张金华[1] 

机构地区：[1]河南省南阳市第二人民医院心内科,473012

出　　处：《中国煤炭工业医学杂志》2011年第4期502-504,共3页Chinese Journal of Coal Industry Medicine

摘　　要：目的观察替罗非班治疗不稳定性心绞痛(UA)的疗效、安全性及主要不良心血管事件(MACE:包括再发心绞痛、急性心肌梗死、心源性猝死)发生率。方法 97例不稳定型心绞痛患者,随机分成观察组49例和对照组48例。观察组在对照组规范治疗(低分子量肝素钙+阿司匹林+氯吡格雷+其他治疗)的基础上,加用替罗非班,负荷量0.4μg/(kg.min),静滴30min,继之维持量0.1μg/(kg.min)持续静滴36h。观察2周时心绞痛发生频率、程度、持续时间、硝酸甘油用量、18导联心电图变化及出血事件,记录6个月内MACE发生率。结果心绞痛症状总有效率观察组91.84%(对照组:72.92%),心电图总有效率87.76%(对照组:70.83%),MACE发生率18.36%(对照组:33.33%),与对照组对比差异有统计学意义(P<0.05);大出血及不明显出血事件发生率二组对比差异无统计学意义(P>0.05),均未出现大出血事件。结论在规范抗血小板、抗凝基础上应用替罗非班治疗UA,疗效确切,能有效控制心绞痛症状,改善缺血性心电图改变,明显降低MACE发生率,且安全性好。Objective To observed the efficacy,safety,and rate of major adverse cardiovascular events（MACE： including recurrent angina,acute myocardial infarction,sudden cardiac death） of unstable angina（UA） treated with Tirofiban.Methods 97 patients with unstable angina were randomly divided into treatment group（49 cases） and control group（48 cases）.Treatment group was treated by Tirofiban based on standard treatment for control group（low molecular weight heparin ＋ aspirin ＋ clopidogrel ＋ other treatments）.Loading 0.4μg/（kg·min）,30-minute intravenous infusion,followed by maintenance dose 0.1μg/（kg·min） 48-hour continuous intravenous infusion.The frequency of angina,degree,duration,nitroglycerin consumption,18-lead ECG changes and bleeding events were observed for 2 weeks,moreover,the MACE occurred rate within 6 months were recorded.Results The total effective rate for symptoms of angina pectoris was 91.84%（control group： 72.92%）,improvement on ECG of 87.76%（control group： 70.83%）,MACE rate of 18.36%（control group： 33.33%）.Compare with control group,they were higher in treatment group with significant differences（P0.05）.There were no bleeding events occurred on treatment and control groups,the rate of no significant bleeding event also showed no difference between the two groups（P0.05）.Conclusion Based on the application of standard anti-platelet and anticoagulation,treated UA with Tirofiban is of the exact effect.It can effectively control symptoms of angina,improve ischemic ECG,significantly reduce the incidence of MACE and have a good security for UA patients.

关 键 词：替罗非班 不稳定性心绞痛 心血管事件 

分 类 号：R541.4[医药卫生—心血管疾病]