替罗非班对急性冠状动脉综合征肝素剂量及血小板的影响

Effects of tirofiban on dose of heparin and platelet aggregation in patients with acute coronary artery syndrome

目的探讨替罗非班对急性冠状动脉综合征患者肝素剂量及血小板计数和功能的影响。方法选择因急性冠状动脉综合征入院患者64例,分为常规治疗组36例和替罗非班组28例,常规治疗组使用抗血小板药和肝素抗凝;替罗非班组在上述基础上联合使用替罗非班,以达到肝素抗凝使激活的部分凝血时间延长2倍为标准,比较两组肝素用量、二磷腺苷(ADP)诱导的血小板聚集及血小板数。结果替罗非班组肝素用量(500±120)U/h显著低于常规组(760±148)U/h,差异有统计学意义(t=7.558,P<0.01),用药后两组的血小板聚集率均显著低于用药前(P<0.01),但替罗非班组降低更显著(P<0.01),替罗非班组用药后血小板数降低(P<0.05)。结论联合应用替罗非班可降低抗凝肝素剂量,显著抑制血小板聚集,并呈降低血小板数的趋势。

Objectives To explore the effects of tirofiban on dose of heparin and platelet aggregation in patients with acute coronary artery syndrome. Methods Sixty-four patients with acute coronary artery syndrome were divided into controlled group （n=36） and tirofiban group （n=28）. Conventional therapies of anti-platelets with aspirin and clopidogrel and anti-coagulation with unfractional heparin were used in controlled group. Tirofiban and conventional therapies were used in tirofiban group. The dose of heparin was adjusted to maintain the activated coagulation time to 2 time prolongation. The dose of heparin, rate of platelet aggregation induced by adenosine diphosphate and platelets count were compared between the two groups. Results The dose of heparin was significant lower in tirofiban group than in controlled [ （500±120） U/h vs （760±148） U/h, P 〈0.01 ]. Rate of platelet aggregation was decreased after 24 h of treatments in the two groups （P〈 0.01）, but was more remarkable in the tirofiban group （P〈 0.01）. The platelets number was significant decreased in the tirofiban groups after 24 h of the treatment （P 〈 0.05 ）. Conclusions Addition to the conventional therapies with anti-platelets and anti-coagulation, tirofiban can reduce the dose of heparin, inhibit platelet aggregation and decrease the platelets number.