不同剂量替罗非班在急性冠状动脉综合征合并糖尿病的老年患者介入治疗中的应用观察  

Efficacy and safety of the peri-procedure use of different dose of tirofiban hydrochloride in the elderly patients with acute coronary syndrome and diabetes mellitus

作　　者：郭文杰[1] 徐伟豪 高荣[3] 兰凯[1] 彭利[1] 张玉霄[1] 卢才义[1] 

机构地区：[1]解放军总医院心血管内科,北京100853 [2]南楼心血管内科 [3]解放军第十医院内科

出　　处：《中华保健医学杂志》2015年第4期277-280,共4页Chinese Journal of Health Care and Medicine

基　　金：北京市科技计划项目(Z131100002613006)

摘　　要：目的评价老年急性冠状动脉综合征（ACS）合并糖尿病（DM）患者介入治疗围手术期加用盐酸替罗非班的安全性和有效性。方法连续选择2012年9月～2014年1月在解放军总医院行冠状动脉支架植入术的老年ACS合并DM患者796例,完成随访739例,根据病历资料,分为无替罗非班组（410例）,半量组（133例）,四分之三量组（137例）和全量组（59例）。观察4组患者术后出血事件发生率,住院期间、术后6个月和12个月主要心血管事件（MACE）发生率。结果全量组主要出血事件、微量出血事件发生率高于无替罗非班组、半量组和四分之三量组（P〈0.05）,半量组、四分之三量组与无替罗非班组出血事件发生率比较,差异无统计学意义（P〉0.05）。4组住院期间、术后6个月、术后12个月MACE发生率比较,半量组、四分之三量组和全量组低于无替罗非班组（P〈0.05）,前3组之间差异无统计学意义（P〉0.05）。结论老年ACS合并DM患者介入治疗围手术期加用盐酸替罗非班抗血小板治疗能有效降低术后主要心血管不良事件的发生率,应用半量或者四分之三量更安全。Objective To evaluate efficacy and safety of the peri-procedure use of tirofiban in the elderly patients with acute coronary syndrome（ACS） and diabetes mellitus（DM）. Methods In a retrospective study with a prospective follow-up,796 elderly patients with ACS and DM undergoing successful stent impl antation were enrolled in this study（complete follow-up 739 cases）.Results The incidence of major bleeding events,minor bleeding events was higher in full dosage group than in no tirofiban group,half dosage group and 3/4 dosage group（p〈0.05）,and the incidence of bleeding events among half dosage group,3/4 dosage group and notirofiban group showed no significant difference（p〈0.05）. During a period of 12 months,we found the use of tirofiban could lower the incidence of major adverse cardiovascular events（MACE）,but no significant difference existed among half dosage group,3/4dosage group and full dosage group. Conclusion Tirofiban hydrochloride can reduce the incidence of MACE in the elderly patients with ACS and DM. But the use of full dose of tirofiban can increase the incidence of bleeding events.

关 键 词：急性冠状动脉综合征 糖尿病 血小板糖蛋白GPⅡb/Ⅲa受体拮抗剂 老年人 

分 类 号：R543.3[医药卫生—心血管疾病]