替罗非班治疗急性非ST抬高型心肌梗死的疗效和安全性评价

Effect and safety of tirofiban in the treatment of acute myocardial infarction of no-stelavalation

目的在应用低分子肝素、阿司匹林、氯吡格雷的基础上,研究替罗非班治疗急性非ST抬高型心肌梗死（NSTEAMI）的疗效和安全性。方法对我院2006.1~2010.10的急性非ST抬高型心肌梗死患者200例,在均使用阿司匹林、氯吡咯雷和低分子肝素的基础上,试验组101例给予替罗非班〔负荷量0.4μg/（kg.min）×30min,然后0.1μg/（kg.min）静脉滴注〕,对照组99例给予安慰剂,疗程2d。结果试验组治疗2h后胸痛缓解率、下移ST段恢复率、超敏CRP的下降、心肌酶谱ck-mb峰值提前程度,明显高于对照组（P〈0.05）;替罗非班组主要不良反应为出血（发生率10%）,与对照组（发生率7%）比较无统计差异（P〉0.05）。结论对于急性非ST抬高型心肌梗死患者,在阿司匹林、氯吡咯雷和低分子肝素治疗基础上,替罗非班可更有效的缓解心肌缺血症状、改善心电图心肌缺血表现,并降低超敏C反应蛋白,且安全性较好。

OBJECTIVE To investigate the efficacy and safety of tirofiban in the treatment of acute myocardial infarction of no-st elavalation on a background of heparin and aspirin therapy.METHODS This was a randomized,double blind and placebo controlled trial.Received concomitant heparin and aspirin,200 patients with acute coronary syndromes were randomized to receive the treatment with tirofiban（load dose 0.4μg/（kg·min）×30min,maintaining dose 0.1μg/（kg·min）（iv drip,n=101） or placebo（n=99） for 2 days.RESULTS There were more obvious improvements in ST segment depression and the number of ischemic leads in the tirofiban group than in the placebo group（P0.05）.There was more reduction in hs-crp in patients with tirofiban（P0.05）.Bleeding occurred in 7% of the patient s receiving placebo and 13% of the patient s receiving tirofiban（P0.05）.CONCLUSION When administered with heparin and aspirin,tirofiban was associated with a lower incidence of ischemic events in patients with acute myocardial infarction of no-st elavalation than in patients who received only heparin and aspirin.