国产替罗非班治疗急性冠状动脉综合征的安全性和有效性

Effect of glycoprotein Ⅱb/Ⅲa receptor inhibitors in 146 patients with acute coronary syndromes

目的观察国产血小板膜糖蛋白Ⅱb/Ⅲa受体拮抗剂替罗非班(欣维宁)在治疗急性冠状动脉综合征(ACS)中的安全性和有效性。方法146例ACS患者随机分为受试组(替罗非班+常规治疗组,73例)和对照组(常规治疗组,73例),疗程24h。结果替罗非班组24h及30d的主要不良心脏事件(MACE)发生率明显低于对照组(24h2.7%比15.1%;30d5.4%比24.7%,P<0.001)。替罗非班组肌钙蛋白T(cTnT)峰值水平(1.47±0.58μg/L)及24h平均水平(1.19±0.54μg/L)均明显较对照组(2.42±0.49μg/L和1.82±0.42μg/L)低(P均<0.01)。替罗非班组和对照组均未见大出血或小出血,皮肤、黏膜出血发生率分别为20.4%和18.9%,二组之间出血并发症发生率差异无统计学意义(P>0.05)。结论替罗非班在ACS的标准治疗基础上能进一步减少心肌缺血事件,并能减少心肌细胞的损伤,且安全性好。

Objective To observe the safety and efficacy ofglycoprotein Ⅱ b/Ⅲ a receptor inhibitors （tirofiban） in the treatment for acute coronary syndromes. Methods The present study registered 146 ACS patients who were randomly divided into the tirofiban group who received tirofiban for 24 h and conventional therapy and the control group who received conventional therapy. Results The major adverse cardiac events （MACE） rates within 24 h （2. 7 % vs 15.1% ） and 30 days （5.4% vs 24. 7% ） in tirofiban group were significantly lower than those in the control group. The peak troponin T levels （ 1.47 ± 0. 58 μg/L） and average levels （1.19 ±0. 54μg/L） within 24 h in the tirofiban group were markedly lower than those in the control, but there were no differences in the incidence of bleeding between two groups （20. 4% vs 18.9%, P 〉 0. 05 ）. Conclusion Tirofiban is safe and can reduce ischemic cardiac events and myocardial injury in treating ACS.