替罗非班对老年ST段抬高型心肌梗死患者PCI术后疗效及安全性观察  

Therapeutic effect and safety observation of tirofiban for elderly patients with myocardial infarction of ST-segment elevation type after PCI

作　　者：王帅[1] 

机构地区：[1]沈阳医学院沈洲医院,辽宁沈阳110002

出　　处：《中国当代医药》2013年第17期97-98,100,共3页China Modern Medicine

基　　金：辽宁省科委基金项目(2012225102)

摘　　要：目的观察老年ST段抬高型心肌梗死患者冠状动脉介入术(PCI)治疗前使用替罗非班的疗效和安全性。方法入选ST段抬高型心肌梗死患者141例,分为3组,试验组(老年、替罗非班组)46例,对照1组(非老年、替罗非班组)41例,对照2组(老年、常规肝素组)54例。试验组及对照1组于PCI术前给予替罗非班,观察各组PCI术后15minTIMI3级血流率,并比较术后30d内主要心血管事件(MACE)的发生率及出血发生率。结果试验组与对照1组相比,术后血流率相似,差异无统计学意义(P>0.05)。试验组与对照2组相比,术后TIMI3级血流率高于对照2组,且差异有统计学意义(P<0.05)。住院期间48h内试验组轻度出血发生率较对照1组及对照2组均无明显增高,差异无统计学意义(P>0.05)。试验组术后30d内主要心血管事件(MACE)的发生率较对照2组明显降低,且差异有统计学意义(P<0.05)。结论在ST段抬高AMI行PCI治疗时应用替罗非班可获得更好的心肌灌注,降低老年患者主要心脏事件的发生,而不良反应并没有增加。Objective To observe the therapeutic effect and safety of tirofiban for elderly patients with myocardial in- farction of ST-segment elevation type after PCI. Methods One hundred and forty one patients with myocardial infarc- tion of ST-segment elevation type were selected and assigned into three groups, 46 cases in trial group （elderly, tirofiban）, 41 cases in control group 1 （non-elderly, tirofiban）, and 54 cases in control group 2 （elderly, conventional hep- arin）. The trial group and control group 1 were rendered tirofiban before PCI. The TIMI grade 3 flow rates at 15 rain af- ter PCI in each group were observed. The incidence of major adverse cardiovascular events （MACE） and bleeding within 30 d after surgery were compared. Results The comparison of trial group and control group 1 showed similar postopera- tive blood flow rate with no significant difference （P 〉 0.05）. The comparison of trial group and control group 2 showed TIMI grade 3 flow of trial group after PCI was higher than that of control group 2 with statistical difference （P 〈 0.05）. The incidence of mild bleeding in trial group within 48 h during hospital stay was not significantly higher than that in control group 1 and 2 with no statistical significance （P 〉 0.05）. The incidence of major adverse cardiovascular events （MACE） in trial group within 30 d after PCI was significantly lower than that of control group 2 with statistical significance （P 〈 0.05）. Conclusion While treating AMI with ST-segment elevation by PCI, applying of tirofiban can get better myocar- dial perfusion, reduce the incidence of major cardiac events in elderly patients, but not increase adverse reaction.

关 键 词：替罗非班 心肌梗死 冠状动脉介入术(PCI) 安全性 

分 类 号：R972[医药卫生—药品]