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目的评价盐酸替罗非班治疗急性冠状动脉综合征的临床疗效及安全性。方法将54例急性冠状动脉综合征患者随机分为对照组26例和试验组28例。对照组予以口服阿司匹林肠溶片50 mg,qd+静脉注射低分子肝素2500 U,再予以静脉滴注500 U·h-1低分子肝素,维持活化部分凝血酶原时间为正常的1.5~2.0倍,2~5 d。试验组在对照组基础上,加用静脉滴注0.4μg·kg-1·min-1盐酸替罗非班30 min,再予以静脉滴注0.1μg·kg-1·min-1盐酸替罗非班,2~5 d。治疗后,比较2组患者治疗后3,30 d内主要心血管不良事件发生率和治疗前后血小板聚集率及不良反应发生率。结果治疗后,试验组血小板聚集率显著低于对照组(P<0.05)。试验组治疗3,30 d主要心血管不良事件发生率分别为3.57%和10.71%显著低于对照组23.08%和34.62%(P<0.05)。试验组和对照组轻微出血事件发生率分别为14.3%和7.7%,差异无统计学意义(P>0.05)。结论盐酸替罗非班联合基础抗凝方案治疗急性冠状动脉综合征是安全、有效的,可显著降低主要心血管不良事件发生率。
Objective To evaluate the clinical efficacy and safety of tirofiban hydrochloride in the treatment of acute coronary syndrome. Methods 54 patients with acute coronary syndrome were randomly divided into control group (n = 26) and experimental group (n = 28). The control group was given oral aspirin enteric-coated tablets 50 mg, qd + intravenous injection of low molecular weight heparin 2500 U, and then given intravenous infusion of 500 U · h-1 low molecular weight heparin to maintain activated partial prothrombin time was 1.5 to 2.0 times normal, 2 ~ 5 d. The experimental group was added with tirofiban 0.4 mg · kg -1 · min -1 hydrochloric acid tirofiban 30 min on the basis of the control group, and then intravenous infusion of 0.1 μg · kg -1 · min -1 hydrochloric acid tirofiban Class, 2 ~ 5 d. After treatment, the incidence of major cardiovascular adverse events and the rate of adverse reactions and platelet aggregation in 3 and 30 d after treatment were compared between the two groups. Results After treatment, the platelet aggregation rate in the experimental group was significantly lower than that in the control group (P <0.05). The incidences of major cardiovascular adverse events at 3 and 30 days in the experimental group were 3.57% and 10.71%, respectively, which were significantly lower than those in the control group (23.08% and 34.62%, P <0.05). The incidences of mild bleeding in trial group and control group were 14.3% and 7.7%, respectively, with no significant difference (P> 0.05). Conclusions The combination of tirofiban plus basic anticoagulation regimen for the treatment of acute coronary syndrome is safe and effective and can significantly reduce the incidence of major adverse cardiac events.