中西医结合疗法在急性冠状动脉综合征急诊介入治疗中的应用

Emergency Interventional Therapy in Patients with Acute Coronary Syndrome with Combination of Traditional Chinese and Western Medicine

目的:观察中西医结合疗法在急性冠状动脉综合征(ACS)经皮行冠状动脉介入治疗(PCI)中的安全性和近期疗效。方法:277例行PCI的ST段抬高ACS患者随机分成2组,治疗组(n=140)运用替罗非班和四妙勇安汤,对照组(n=137)未使用替罗非班组和四妙勇安汤。观察2组患者用药后TIMI血流分级、出血情况、记录住院期间及随访3个月时的主要心血管事件(心源性死亡、非致死性心肌梗死及再发心绞痛)的发生率。结果:用替罗非班组达到TIMI3级血流的患者为91.43%;对照组达到3级血流的患者为81.029%,2组差异有统计学意义(P<0.05)。2组出血发生率比较无统计学意义(P>0.05)。住院期间和随访3个月均无主要心血管事件发生。结论:在常规药物基础上加用替罗非班和四妙勇安汤治疗高危ST段抬高ACS是安全且有效的。

Objective ：To observe the safety and short - term outcomes of domestic tirofiban in patients with ST elevation acutecoronary syndrome（STEACS） undergoing pereutaneous coronary intervention （PCI）. Methods：Two hundred and seventy- seven patients with STEACS were enrolled in the study and divided into two groups：the tirofiban group （n = 140 ） and the control group （n = 137 ）. TIMI grade, bleeding rate in both groups were investigated and compared before and after PCI. Major adverse cardiac events were also recorded in hospital and during 3 months＇ follow -up. Results：Ninty -one percent of patients in the tirofiban group compared with 81% in the control group obtained TIMI grade 3 flow （ P 〈 0. 05 ）. There was no significant difference in the incidence of bleeding between two groups （ P 〉 0. 05 ）. There were no serious bleeding complications and MACE in - hospital and follow - up period. Conclusion ： Additional use of tirofiban on the basis of conventional drug is safe and effective in thetreatment of high - risk ST elevation acutecoronary syndrome.