早期使用替罗非班联合不同调脂药对老年冠心病患者经冠状动脉介入治疗的临床观察  

Clinical Observation of Early Application of Tirofiban Combined with Different Lipid-regulating Drugs Intervention in Elderly Patients with Coronary Heart Disease

作　　者：程杰[1] 冯丽伟[2] 

机构地区：[1]上海中医药大学附属曙光医院药剂科,上海200021 [2]上海中医药大学附属曙光医院急诊科,上海200021

出　　处：《中国药房》2015年第29期4118-4121,共4页China Pharmacy

摘　　要：目的:观察早期使用替罗非班联合不同调脂药对老年冠心病患者经冠状动脉介入治疗(PCI)的短期疗效及安全性。方法:选取择期行PCI的老年冠心病患者562例,按照随机数字表法分为阿托伐他汀组和普罗布考组,各281例。两组患者均行常规治疗,阿托伐他汀组患者在常规治疗基础上给予替罗非班联合阿托伐他汀钙片治疗;普罗布考组患者在常规治疗基础上给予替罗非班联合普罗布考片治疗,比较两组患者治疗前后各项临床指标及不良心脏事件(MACE)。结果:治疗后阿托伐他汀组心肌梗死溶栓(TIMI)3级患者比例为69.4%,低于普罗布考组的95.7%,差异有统计学意义(P<0.05);两组患者治疗12 h后肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、左室射血分数(LVEF)均降低,肌钙蛋白I(c Tn I)升高,阿托伐他汀组患者LVEF下降更显著,差异均有统计学意义(P<0.05);普罗布考组患者治疗8周后一氧化氮(NO)、NO/内皮素(ET)-1、还原性谷胱甘肽(GSH)、GSH/氧化性谷胱甘肽(GSSG)较治疗前显著升高,ET-1、GSSG、氧化还原电位(Eh)较治疗前显著降低,阿托伐他汀组患者上述指标均未见明显变化,组间比较差异均有统计学意义(P<0.05);阿托伐他汀组和普罗布考组患者治疗期间主要MACE发生率分别为21.7%、21.4%,差异无统计学意义(P>0.05)。结论:替罗非班联合不同调脂药均可有效改善老年冠心病患者PCI预后且安全性较好,但替罗非班联合普罗布考片具有更为明显的治疗效果。OBJECTIVE：To observe short-term efficacy and safety of early use of tirofiban combined with different lipid-regulating drugs percutaneous coronary intervention（PCI）in elderly patients with coronary heart disease. METHODS：562 elderly patients with coronary heart disease underwent selective PCI were selected and randomly divided into atorvastatin group and probucol group,with 281 cases in each group. Both group received routine treatment;atorvastatin group was additionally given tirofiban combined with Atorvastatin tablet,and probucol group was additionally given irofiban combined with Probucol tablet. Clinical indicators and main adverse cardiac event（MACE）were compared between 2 groups before and after treatment. RESULTS：After treatment,3 level of thrombolysis in myocardial infarction（TIMI）in atorvastatin group accounted for 69.4%,which was significantly lower than 95.7% of probucol group,with statistical significance（P〈0.05）. After 12 h treatment,CK,2 groups had lower CK-MB and LVEF and higher c Tn I;LVEF decrease of atorvastatin group was more significant,with statistical significance（P〈0.05）;after 8 weeks of treatment,NO,NO/ET-1,GSH,GSH/GSSG of probucol group were increased significantly,and ET-1,GSSG and Eh decreased significantly;above indexes of atorvastatin group had no significant change,there was statistical significance between2 groups（P〈0.05）. The incidence of MACE in atorvastatin group and probucol group were 21.7% and 21.4%,there was no significant difference（P〉0.05）. CONCLUSIONS：Tirofiban combined with different lipid-regulating drugs can effectively improve the prognosis of elderly patients with coronary heart disease after PCI operation with good safety,but tirofiban combined with probucol has more obvious therapeutic effect.

关 键 词：替罗非班 阿托伐他汀 普罗布考 老年 冠心病 经冠状动脉介入治疗 

分 类 号：R541.4[医药卫生—心血管疾病] R972.6[医药卫生—内科学]