论文部分内容阅读
目的研究老年高危急性冠状动脉综合征(ACS)国人经皮冠状动脉介入术(PCI)中应用替罗非班的有效性和安全性。方法将2004年12月至2006年6月连续的94例老年高危ACS患者随机分为替罗非班治疗组和常规PCI组,前者PCI术前给予替罗非班+半量肝素治疗,后者仅以全量肝素治疗,比较两组PCI术后即刻罪犯血管(CV)的TIMI血流分级,术后6、12h肌酸激酶同工酶(CK-MB)的改变以及术后30d内的主要不良心脏事件(MACE)的发生率、术后出血的发生率和需要输血的比例。结果术后即刻替罗非班组和常规PCI组CV的TIMI血流分级(计帧法)分别为35.6±6.1和38.7±8.2;两组6、12h的CK-MB分别为16.2±3.9mmol/L、13.4±3.9mmol/L和18.4±4.8mmol/L、15.5±5.1mmol/L(P<0.05),而两组间术后30d的MACE发生率以及术后出血、输血的比例差异无统计学意义。结论老年高危ACS患者介入术中使用血小板膜糖蛋白Ⅱb/Ⅲa受体拮抗剂替罗非班是安全、有效的,其疗效优于常规治疗。
Objective To study the efficacy and safety of tirofiban in percutaneous coronary intervention (PCI) in elderly patients with high-risk acute coronary syndrome (ACS). Methods A total of 94 consecutive elderly patients with high-risk ACS from December 2004 to June 2006 were randomly divided into tirofiban treatment group and conventional PCI group. The former was treated with tirofiban plus half-heparin before PCI, while the latter only Total heparin was used to compare TIMI flow grade of the criminals immediately after PCI, changes of creatine kinase isoenzyme (CK-MB) at 6 and 12 hours after surgery, and major adverse cardiac Incidence of events (MACE), the incidence of postoperative bleeding and the need for blood transfusions. Results The TIMI grade of blood flow was 35.6 ± 6.1 and 38.7 ± 8.2, respectively in the two groups after 6 and 12 hours of treatment. The CK-MB of the two groups were 16.2 ± 3.9mmol / L , 13.4 ± 3.9mmol / L, 18.4 ± 4.8mmol / L and 15.5 ± 5.1mmol / L respectively (P <0.05). There was no significant difference in the incidence of MACE between the two groups and the postoperative bleeding and blood transfusion significance. Conclusion The use of platelet membrane glycoprotein Ⅱb / Ⅲa receptor antagonist tirofiban in elderly high-risk ACS patients is safe and effective, and its efficacy is superior to conventional treatment.