半量替罗非班在老年急性心肌梗死急诊经皮冠状动脉介入治疗的疗效和安全性  

Efficacy and safety of half tirofiban dose in elderly patients with ST-segment elevation acute myocardial infarction after PCI

作　　者：任琳[1] 王文广[1] 王倩[1] 张晶[1] 汤秀英[1] 冯建双 杨红梅[1] 王庆胜[1] 

机构地区：[1]秦皇岛市第一医院CCU,066000

出　　处：《中华老年心脑血管病杂志》2014年第1期32-35,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的 探讨半量替罗非班对老年急性ST段抬高心肌梗死（STEMI）患者急诊PCI的疗效及安全性.方法 入选STEMI行急诊PCI老年患者114例,随机分为标准剂量组56例和半量组58例.标准剂量组给予替罗非班0.10~0.15 μg/（kg·min）静脉滴注48 h,半量组给予0.05~0.075 μg/（kg·min）静脉滴注24 h.比较2组TIMI及心肌染色分级（MBG）2~3级血流率,术后90 min的ST段回落百分比（sumSTR）、LVEF、左心室舒张末和收缩末内径变化及主要心脏不良事件、出血、消化道不良反应的发生率.结果 标准剂量组TIMI及MBG 2~3级血流率较半量组虽有升高趋势,但差异无统计学意义（P〉0.05）;2组术后90 min的sumSTR〉50%比例及患者住院期间不良事件发生率比较,差异无统计学意义（P〉0.05）;半量组出血发生率低于标准剂量组（3.45% vs 16.07%,P〈0.05）.结论 半量替罗非班在预防缺血方面的疗效与标准剂量相当,但在出血风险方面的安全性明显升高.Objective To study the efficacy and safety of half tirofiban dose in elderly patients with STEMI after PCI. Methods One hundred and fourteen STEMI patients after PCI were randomly divided into standard tirofiban dose group （n=56） and half tirofiban dose group （n=58）. Patients in standard tirofiban dose group were intravenously injected with tirofiban at the dose of 10 μg/kg within 3 min followed by intravenous infusion at athe dose of 0.10-0.15 μg/（kg · min） for 48 h and those in half tirofiban dose group were intravenously injected with tirofiban at the dose of 5 μg/kg within 3 min followed by intravenous infusion at the dose of 0.05-0. 075 μg/（kg · min） for 24 h. The following parameters were compared between the two groups,inclusing thrombolys- is in myocardial infarction （TIMI） ,MBG 2-3 blood flow,resolution of the sum of ST-segment el- evation （sum-STR） 90 min after operation,and LVEF, LVEDD, LVESD, and incidence of major adverse cardiovascualr events, bleeding and gastrointestinal symptoms after operation. Results No significant difference was found in the TIMI,MBG 2-3 blood flow,sum-STR〉50% ,and inci- dence of adverse events 90 min after operation between the two groups,although they were higher in standard tirofiban dose group than in half tirofiban dose group （P〈0.05）. The incidence of bleeding was significantly lower in half tirofiban dose group than in standard tirofiban dose group （3. 45% vs 16.07% ,P〈0.05）. Conclusion The efficacy of standard tirofiban dose and half tiro- fiban dose is similar in prevention of ischemia. However,the safety of half tirofiban dose is better than that of standard tirofiban dose in prevention of bleeding risk.

关 键 词：心肌梗死 血小板糖蛋白GPⅡb-Ⅲa复合物 血小板聚集抑制剂 超声心动描记术 多普勒 彩色 心肌再灌注 替罗非班 

分 类 号：R542.22[医药卫生—心血管疾病]