小剂量替罗非班治疗高原非ST段抬高型急性冠脉综合征的临床观察  

Clinical observation of low-dose tirofiban in patients with non-ST segment elevation acute coronary syndrome at high altitude

作　　者：吴久健[1] 姜大春[2] 尹刚[1] 虞慎也[1] 吴鹏[1] 石国芹[1] 

机构地区：[1]解放军第37医院药械科,四川雅安625000 [2]解放军第37医院心内科,四川雅安625000

出　　处：《心脏杂志》2011年第5期620-622,共3页Chinese Heart Journal

基　　金：成都军区医学科研计划课题资助(MB09016)

摘　　要：目的:观察小剂量替罗非班治疗高原非ST段抬高型急性冠脉综合征(NSTE-ACS)患者的疗效及安全性。方法:将75例NSTE-ACS患者随机分为对照组(n=37)和观察组(n=38)。两组均常规使用阿司匹林、氯吡格雷、低分子肝素等药物治疗,观察组加用小剂量替罗非班[负荷量0.3μg/(kg.min)×30 min,维持量0.05μg/(kg.min)×72 h]微量泵静脉泵入。检测治疗前后血小板计数和血小板聚集率;观察30 d内心血管事件和出血事件的发生率。结果:对照组30 d内心血管事件的发生率为22%,观察组为5%,两组间有显著差异(P<0.05);对照组30 d内出血事件的发生率为5%,观察组为8%,两组间无显著差异;对照组血小板聚集率治疗前后无显著变化,观察组治疗后血小板聚集率显著降低(P<0.05)。两组患者中均未观察到血小板减少的发生。结论:小剂量替罗非班联合阿司匹林、氯吡格雷和低分子肝素治疗高原NSTE-ACS是安全和有效的。AIM：To observe the effectiveness and safety of low-dose tirofiban in patients with non-ST segment elevation acute coronary syndrome （NSTE-ACS） at high altitude. METHODS： A total of 75 patients with NSTE-ACS were randomized into control group （n=37） and tirofiban group （n=38）. Patients in both groups were treated with aspirin, clopidogrel and low molecular weight heparin therapy. Patients in tirofiban group were treated with tirofiban [load dose 0.3 μg/（kg·min）×30 min, maintaining dose 0.05 μg/（kg·min）×72 h]. Platelet count and platelet adhesion rate were measured before and after tirofiban treatment. Incidence of cardiovascular events and hemorrhage within 30 days were recorded. RESULTS： Incidence of cardiovascular events within 30 days in control group was significantly higher than in tirofiban group （22% vs. 5%, P〈0.05）. Incidence of hemorrhage was similar between groups （5% vs. 8%, P〉0.05）. Platelet adhesion rate was significantly reduced in tirofiban group but no similar change was seen in control group. No reduction of platelet count was observed in either group. CONCLUSION： Treatment with low-dose tirofiban is an effective and safe strategy for patients with NSTE-ACS at high altitude.

关 键 词：高原 替罗非班 急性冠脉综合征 

分 类 号：R541.4[医药卫生—心血管疾病]