非ST段抬高型急性冠状动脉综合征高龄患者应用替罗非班强化抗栓治疗的临床评价  

Evaluation of antithrombotic efficacy and safety for tirofiban in treatment of senile non-ST- elevation acute coronary syndrome

作　　者：李毅[1] 冯艳林[1] 白怀生[2] 马瑞[1] 

机构地区：[1]延安市人民医院老年病科,716000 [2]延安大学附属医院心血管内科

出　　处：《中国医师进修杂志》2014年第34期60-62,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：【摘要】目的评价强化抗栓治疗（阿司匹林、氯吡格雷联合替罗非班）高龄（〉175岁）非ST段抬高型急性冠状动脉综合征（NsTEAcs）患者的有效性和安全性。方法人选高龄NSTEACS患者146例，按随机数字表法分为观察组（70例）和对照组（76例）。对照组给予阿司匹林、低分子量肝素、氯吡格雷等常规治疗；观察组在常规治疗基础上加用替罗非班[静脉负荷量0．4μg／（kg·min），30min后以0．1μs／（kg·min）维持，持续48～72h]。观察两组患者30d主要心血管事件（MACE）、7d心绞痛症状缓解程度及出血等不良反应的发生情况。结果观察组30d的MACE发生率为5．7％（4，70），对照组为14．5％（11/76），两组比较差异有统计学意义（P〈0．05）。观察组与对照组7d心绞痛症状缓解总有效率分别为92．9％（65，70）和76.3％（58／76），差异有统计学意义（P〈0．05）。观察组与对照组出血发生率分别为10．0％（7/70）和7．9％（6，76），差异无统计学意义（P〉0．05）。两组均无严重的出血并发症，观察组发生1例血小板减少，但与对照组比较差异无统计学意义（P〉0．05）。结论替罗非班强化抗栓治疗高龄NSTEACS患者，能有效缓解心绞痛症状，降低30d的MACE发生率，不增加出血风险。Objective To evaluate the safety and efficacy of radical antithrombotic therapy（aspirin, clopidogrel and tirofiban） in the treatment of senile （ ≥75 years） non-ST-elevation acute coronary syndrome （NSTEACS）. Methods A total of 146 senile patients with NSTEACS were divided into observation group （70 cases） and control group（76 cases） by random digits table method. The control group was given aspirin, low molecular weight heparin and clopidogrel, and the observation group was added tirofiban （intravenous loading dosage：0.4 μg/ （kg＇min） for 30 min and then maintaining 0.1μg/ （kg·min） for 48 - 72 h）. The occurrence of major adverse cardiovascular events （MACE） within 30 d after treatment, 7 d angina pectoris control rate and adverse reactions were observed in two groups. Results The occurrence rate of MACE within 30 d after treatment was 5.7 % （4/70） in observation group, and 14.5 % （11/76） in control group, and there was significant difference （P 〈 0.05）. The 7 d angina pectoris control rate was 92.9% （65/70） and 76.3 % （58/76） in observation group and control group, and there was significant difference （P 〈 0.05 ）. The incidence of bleeding was 10.0% （7/70） and 7.9% （6/76） in observation group and control group, and there was no significant difference （P 〉 0.05）. There were no major bleeding events in two groups. One case had thrombocytopenia in observation group, but there was no significant difference compared with that in control group（P 〉 0.05）. Conclusion Triofiban on the basis of aspirin and clopidogrel in the treatment of senile NSTEACS is effective and safe.

关 键 词：老年人 急性冠状动脉综合征 安全 替罗非班 

分 类 号：R541.4[医药卫生—心血管疾病]