替罗非班联合瑞替普酶治疗急性心肌梗死安全性分析  

Safety of combination reperfusion therapy with tirofiban and half - dose reteplase in STEMI

作　　者：卞秋武[1] 王乐[1] 王雪青[1] 张双月[1] 王庆胜[1] 林海龙[2] 谭强[1] 杨红梅[1] 王晓亮[1] 王文广[1] 

机构地区：[1]河北医科大学附属秦皇岛市第一医院心内科,河北秦皇岛066200 [2]大连医科大学附属大连市中心医院心内科,辽宁大连116033

出　　处：《中国急救医学》2013年第7期630-633,共4页Chinese Journal of Critical Care Medicine

基　　金：河北省科技研究与发展计划项目（072761619）

摘　　要：目的 探讨替罗非班联合半量瑞替普酶用于急性ST段抬高性心肌梗死治疗的安全性.方法 2007-01～2011-12入选我院急性ST段抬高性心肌梗死患者208例,随机分为联合溶栓组及标准瑞替普酶组.比较两组30 d内各种原因导致的死亡、心力衰竭或肺水肿、室性心动过速或心室颤动、非致死性再梗死、心肌缺血复发等临床事件发生率,以及轻度、中度、严重出血及脑出血事件发生率.结果 两组患者死亡、心源性休克、心室颤动、Ⅱ~Ⅲ度房室传导阻滞、补救性经皮冠状动脉介入治疗（PCI）事件发生率比较差异无统计学意义,联合溶栓组非致死性心肌再梗死发生率、心肌缺血、室性心动过速、心力衰竭及肺水肿发生率明显低于标准瑞替普酶组.两组轻度出血、中度出血、严重或威胁生命的出血及总的出血发生率比较差异无统计学意义.结论 替罗非班联合半量瑞替普酶溶栓用于急性ST段抬高性心肌梗死治疗与标准瑞替普酶溶栓比较,安全性方面相似.Objective To investigate the therapeutic safety of combination reperfusion therapy of tirofiban with half - dose reteplase in acute ST segment elevation myocardial infarction （STEMI）. Methods 208 patients with STEMI in our hospital were randomly divided into half- dose reteplase with full - dose tirofiban （ group A） or standard - dose reteplase （ group B）. During the 30 days of reperfusion therapy, the incidence of death by various kinds of causes, heart failure or pulmonary edema, ventricular tachycardia or ventricular fibrillation, reinfarction, myocardial ischemia recurrence and hemorrhage between two groups were compared. Results There was no difference in mortality rate between A group and B group, but A group showed a fewer ratio in recurrent myocardial infarction, recurrent ischaemia, ventricular tachycardia or fibrillation, severe pump failure. There was no difference in ratio for life -threatening bleeding, hyporrhea, midrange hemorrhage between two groups. Conclusion The safety of combination reperfusion therapy with tirofiban and half - dose reteplase for STEMI is similar to standard -dose reteplase.

关 键 词：溶栓治疗 急性心肌梗死 瑞替普酶 替罗非班 

分 类 号：R654.2[医药卫生—外科学]