替罗非班不同给药持续时间在急性心肌梗死患者中的应用  

The application of different administrated duration of tirofiban in the patients with acute myocardial infarction

作　　者：游翠芳[1] 罗瑞英[2] YOU Cui-fang;LUO Rui-ying(Department of pharmacy, The Affiliated Ningde City Hospital of Fujian Medical University, Ningde, Fujian, 352100, China)

机构地区：[1]福建医科大学附属宁德市医院药学部,宁德352100 [2]福建医科大学附属宁德市医院心血管内科,宁德352100

出　　处：《中国循证心血管医学杂志》2016年第8期986-988,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的探讨替罗非班不同给药持续时间在急性心肌梗死（AMI）患者介入治疗围术期中的临床效果。方法选取2012年5月~2014年5月在福建医科大学附属宁德市医院住院行冠状动脉介入治疗的108例AMI患者，随机分为给药48h组[替罗非班起始30min负荷量0.4μg/（kg·min），后以0.1μg/（kg·min）的速率持续48h]；给药24h组[替罗非班起始30min负荷量0.4μg/（kg·min），后以0.1μg/（kg·min）的速率持续24h]与对照组，每组各36例。比较三组患者术前与治疗后的血小板数，血小板聚集率，以明确血栓及出血风险；测定左心室收缩末期内径（LVESD）、短轴收缩率（FS）和左室射血分数（LVEF），以明确各组发生主要不良心血管事件情况（MACE）。结果给药48h组治疗后的血小板计数、血小板聚集等指标均优于给药24h组（P＜0.05）；三组治疗后LVESD、FS、LVEF及治疗后出血事件发生率比较差异无统计学意义（P＞0.05）；给药48h组治疗后MACE发生率显著低于给药24h组与对照组（P＜0.05）。结论给药48h组的替罗非班可有效抑制血小板功能，减少AMI患者PCI术后的MACE发生率。Objective To investigate the clinical effects of different administrated duration of tirofiban on the acute myocardial infarction (AMI) patients in perioperative period of percutaneous coronary intervention (PCI).Methods 108 AMI patients who were treated in the affiliated Ningde city hospital of Fujian Medical University and received PCI from May 2012 to May 2014, were divided into three groups randomly: 48 h group [with tirofiban loading dose 0.4μg/(kg·min) for 30 min and then 0.1μg/(kg·min) for 48 h], 24 h group [with tirofiban loading dose 0.4μg/(kg·min) for 30 min and then 0.1μg/(kg·min) for 24 h] and the control group. Each group have 36 patients. The platelet count and platelet aggregation rate before and after treatment were compared among three groups to verify the risk of thrombus and bleeding. Left ventricular end systolic diameter (LVESD), minor shrinkage (FS) and left ventricular ejection fraction (LVEF) were measured in order to verify the incidence of major adverse cardiovascular events case (MACE) of each group. Results The platelet count and platelet aggregation of 48 h group were significantly lower than 24 h group (P<0.05). There were no significant difference with respect to LVESD, FS, LVEF and the incidence rate of bleeding events among three groups after treatment (P>0.05). Conclusion Tirofiban in 48 h group can effectively inhibit function of platelet, reduce the incidence of MACE in patients with AMI after PCI.

关 键 词：急性心肌梗死 介入治疗 围手术期 替罗非班 

分 类 号：R541.4[医药卫生—心血管疾病]