摘要
目的:探讨盐酸替罗非班对非ST段抬高急性冠脉综合征(NSTE-ACS)患者早期介入治疗的疗效和安全性。方法:选择NSTE-ACS的中高危患者95例,随机分为替罗非班试验组(n=48)和对照组(n=47),均于入选后72h内接受早期PCI治疗。比较两组间基础临床资料、PCI前后病变血管血流TIMI分级、术后12h血清肌钙蛋白(cTnT)和肌酸激酶同工酶(CK-MB)水平、出血事件和血小板减少以及30d主要心血管事件(MACE)的发生率。结果:试验组和对照组最终分别入选了47例和44例患者。两组间基础临床资料无统计学差异,试验组应用替罗非班后PCI术前病变血管前向血流达到TIMI3级的比率高于对照组(61.7%vs47.7%,P<0.05),术后TIMI3级血流获得率试验组较对照组高(95.7%vs88.6%),但未达到统计学差异;术后试验组cTNT和CK-MB升高发生率较对照组明显减低(10.6%vs20.5%,P<0.05)。两组出血事件和血小板减少以及30dMACE发生率差异无统计学意义(P>0.05)。结论:NSTE-ACS患者早期介入治疗术前应用盐酸替罗非班是安全有效的,能够提高PCI术前病变血管前向血流,并减少PCI术后的心肌损伤。
Objective: To explore the efficacy and safety of tirofiban used in early PCI for patients with non-ST elevation acute coronary syndrome (NSTE-ACS). Methods: Ninety-five middle-high risk patients with NSTE-ACS were randomly divided into two groups: the tirofiban group (n = 48) and the control group (n = 47). All patients received early PCI within 72 hours. Basic clinical characteristics, TIMI flow before and after PCI, serum level of cTnT and CK-MB after PCI, incidences of bleeding and thrombocytopenia in the hospital, and the incidences of major adverse cardiac events (MACE) at 30th day were compared between two groups. Results: Totally 91 NSTE-ACS patients were accomplished this study (tirofiban group, 47cases, control group: 44 cases). There were no significant differences in basic clinical characteristics between the two groups. The percentage of TIMI 3 flow achieved in tirofiban group before PCI was higher than that in control group (61.7% vs 47. 7%, P〈0. 05), but there were no significant difference in percentage of TIMI 3 flow achieved after PCI between the two groups. The incidence of increased cTnT and CK MB in tirofiban group was significantly lower than that in control group (10. 6% vs 20. 5%, P〈0. 05) after intervention. There were no significant differences in occurrence of bleeding complication and MACE in both groups (P〉0. 05). Conclusions.. It is safe and effective for pre-angiographic use of tirofiban in early PCI for patients with non-ST elevation acute coronary syndrome. Tirofiban can increase blood flow before PCI, improve myocardial perfusion, and reduce myocardial injury after PCI.
出处
《内科急危重症杂志》
2009年第1期17-19,共3页
Journal of Critical Care In Internal Medicine
基金
河北省邯郸市科学技术研究与发展计划项目课题(No:072317099)
关键词
急性冠脉综合征
替罗非班介入治疗
Acute coronary syndrome Tirofiban Interventional therapy