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目的:探讨替罗非班围手术期应用对行药物洗脱支架(DES)置入老年冠心病患者出血、血小板减少及主要不良心血管事件(MACE)发生风险的影响。方法:研究对象选取某院2011年1月-2015年6月收治行DES置入老年冠心病患者共200例,采用随机数字表法分为对照组(100例)和观察组(100例),分别在术后给予常规二联抗血小板方案单用和在此基础上加用替罗非班治疗,比较2组患者TIMI出血分级情况、血小板减少率及随访MACE发生率等。结果:2组患者TIMI出血分级情况比较差异无统计学意义(P>0.05);2组患者血小板减少率比较差异无统计学意义(P>0.05);同时观察组患者随访MACE发生率显著低于对照组,差异有统计学意义(P<0.05)。结论:替罗非班围手术期应用用于行DES置入老年冠心病患者可有效降低远期MACE发生风险,改善临床预后,且未导致术后出血和血小板减少情况加重。
Objective: To investigate the impact of perioperative application of tirofiban on the risk of hemorrhage, thrombocytopenia and major adverse cardiovascular events (MACE) in elderly patients with coronary heart disease undergoing drug-eluting stents (DES). Methods: A total of 200 elderly patients with coronary heart disease admitted to our hospital from January 2011 to June 2015 in our hospital were selected and divided into control group (100 cases) and observation group (100 cases) by random number table. The patients were given routine antiplatelet therapy combined with tirofiban after operation, and the TIMI grade, thrombocytopenia rate and the follow-up rate of MACE were compared between the two groups. Results: There was no significant difference in TIMI hemorrhage grade between the two groups (P> 0.05). There was no significant difference in thrombocytopenia between the two groups (P> 0.05). The incidence of MACE at follow-up in the observation group was significantly lower than Control group, the difference was statistically significant (P <0.05). Conclusion: Perioperative application of tirofiban in elderly patients with coronary artery disease undergoing DES implantation can effectively reduce the risk of long-term MACE and improve the clinical prognosis, without causing postoperative bleeding and thrombocytopenia.