围介入术期应用替罗非班治疗高危非ST段抬高型急性冠脉综合征的临床疗效及安全性研究  

Efficacy of Tirofiban on Perioperative High-risk Non-ST-segment Elevation Acute Coronary Syndrome and Its Safety

作　　者：刘士超[1] 简立国[1] 丁同斌[1] 赵江涛[1] 成媛[1] 

机构地区：[1]郑州大学第二附属医院心内科,河南省郑州市450003

出　　处：《中国全科医学》2013年第26期3072-3074,共3页Chinese General Practice

摘　　要：目的探讨围介入术期应用替罗非班治疗高危非ST段抬高型急性冠脉综合征(NSTE-ACS)的临床疗效及安全性。方法选择2011年1月—2013年2月在我院住院的高危NSTE-ACS患者95例,采用系统随机化法分为对照组47例和试验组48例。两组患者术前均给予阿司匹林、氯吡格雷抗凝,行冠状动脉造影术(CAG)及经皮冠状动脉介入治疗(PCI)。试验组加用替罗非班。比较两组患者PCI前后TIMI血流分级、主要心血管事件(MACE)及出血并发症发生率。结果两组患者PCI前TIMI血流3级、2级、1级、0级率比较,差异均无统计学意义(P>0.05);术后TIMI血流1级、0级率均为0,而试验组TIMI血流3级率高于对照组,TIMI血流2级率低于对照组,差异均有统计学意义(P<0.05)。两组患者均未出现死亡及心包填塞,试验组术中无复流、血管远端栓塞、再发心肌梗死及心绞痛发生率低于对照组,差异均有统计学意义(P<0.05);两组患者严重出血、轻度出血、血小板减少发生率比较,差异均无统计学意义(P>0.05)。结论围介入术期应用替罗非班治疗高危NSTE-ACS安全有效,可改善患者TIMI血流、增加组织灌注,降低MACE及出血并发症发生率。Objective To study the clinical efficacy of tirofiban on perioperative high - risk non - ST segment eleva- tion acute coronary syndromes （ NSTE - ACS） and its safety. Methods A total of 95 NSTE - ACS patients admitted to our hos- pital between January 2011and February 2013 were divided randomly into groups control （n = 47） and treatment （n = 48 ）. Both groups were given aspirin, clopidogrel anticoagulation before operations, and had coronary angiography （CAG） and percu- taneous coronary intervention （PCI）. Tirofiban was added in treatment group. Tirofiban was added in treatment group. TIMI flow grading and incidences of major adverse cardiovascular events （MACE） , bleeding complications were compared between 2 groups before and after PCI. Results There was no significant difference in rate of TIMI grades 3, 2, 1, 0 between 2 groups before PCI （P 〉 0. 05）, and after PCI, rate of TIMI 1, 0 were 0 in 2 groups, but that of TIMI 3 was higher, that of TIMI 2 lower in treatment group than control group, the difference was significant （ P 〈 0.05 ）. No death or cardiac tamponade occurred in 2 groups, and the incidences of no - reflow, vascular distal embolization, recurrent myocardial infarction, angina were lower in treatment group than in control group （ P 〈 0. 05 ）. No difference was noted in incidence of severe bleeding, minor bleeding, thrombocytopenia between 2 groups （P 〉 0. 05 ）. Conclusion Tirofiban in NSTE - ACS treatment in pefioperative period, safe and effective, can improve TIMI flow, increase tissue perfusion, reduce incidence of MACE and bleeding complications.

关 键 词：急性冠状动脉综合征 围介入术期 替罗非班 治疗结果 安全 

分 类 号：R543.31[医药卫生—心血管疾病]