半剂量与常规剂量盐酸替罗非班在老年急性心肌梗死的患者行急诊PCI治疗的有效性与安全性  

Investigation of the Efficacy and Safety of Half-dose Tirofiban and Standard-dose Tirofiban in Emergency PCI Treatment of Elderly Patients with Acute Myocardial Infarction

作　　者：张爱华[1] 沈彬[1] 赵勇 张宇晨 朱正炎[1] 张建国[1] 马军力 ZHANG Ai-hua;SHEN Bin;ZHAO Yong(Department of Cardiology,China Medical University Shunyi Hospital,Beijing,10l300,China)

机构地区：[1]中国医科大学顺义医院心内科,北京101300 [2]首都医科大学附属北京安贞医院北京市心肺血管疾病研究所心内科,北京100029

出　　处：《黑龙江医学》2019年第6期623-626,共4页Heilongjiang Medical Journal

基　　金：区科委科研项目:北京市顺义区科技三项费项目

摘　　要：目的探讨半剂量血小板膜蛋白(GP)Ⅱb/Ⅲa受体拮抗剂在在老年患者直接PCI治疗的疗效及安全性。方法连续入选2015年6月—2017年8月就诊并行直接PCI的急性ST段抬高型心肌梗死(STEMI)患者99名,随机分为半剂量干预组和常规治疗剂量干预组(B组),观察出血等并发症。结果半剂量干预组51例,常规治疗剂量干预组48例,2组间基础临床资料差异无统计学意义(P>0.05)。A组较B组出血并发症有减少趋势(9.8%:18.8%);术后支架内血栓形成的并发症相比较,差异无统计学意义(P>0.05);血小板减少在B组术前及术后24h比较,差异有统计学意义(P<0.05)。结论半剂量的欣维宁在老年STEMI患者行直接PCI治疗使用是安全有效的,我们建议在高出血风险患者使用半量欣维宁抗血栓治疗。Objective To evaluate the efficacy and safety of usage of platelet membrane glycoprotein(GP)Ⅱb/Ⅲa inhibitor tiro? fiban for primary percutaneous coronary interventional(PCI)in elderly patients with acute ST segment elevation myocardial infarction (STEMI). Methods A total of 99 elderly patients who suffered from STEMI and underwent PCI from June,2015 to August,2017 were selected. The patients were randomly assigned to two groups:half-dose tirofiban group(A group)and standard-dose tirofiban group(B group). The complications and bleeding of two groups were observed. Results There were 51 patients in the half-dose tirofi? ban group,and 48 patients in the standard-dose tirofiban group. There was no statistically significant difference in basic clinical data in two groups,P>0.05. Complications,such as bleeding,in A group decreased compared with B group(9.8%:18.8%). There was no statistically significant difference in complications caused by sent thrombosis after surgery,P>0.05. There was statistically significant difference in thrombocytopenia in B group before and after 24h in two groups,P>0.05. Conclusion It is efficient and safe to use GP Ⅱb/Ⅲa inhibitor tirofiban for primary percutaneous coronary interventional(PCI)in elderly patients with STEMI. Half-does tirofiban can offer the same level of efficacy as standard-dose,with less associated bleeding.

关 键 词：替罗非班 老年患者 心肌梗死 经皮冠脉成形术 

分 类 号：R542.22[医药卫生—心血管疾病]