盐酸替罗非班治疗老年非ST抬高心肌梗死疗效观察

Efficacy of Hydrochloride Tirofiban in The Treatment of Elderly NSTEMI

目的:探讨老年非ST抬高心肌梗死(NSTEMI)患者应用盐酸替罗非班后主要不良心血管事件(MACE)的发生情况及安全性。方法:92例未接受冠脉介入治疗的老年NSTEMI患者随机分为观察组47例和对照组45例,两组患者常规药物治疗相同,观察组加用盐酸替罗非班注射液静脉微量泵持续泵入,负荷量0.4 g.kg-1.min-1,30 min后以0.1 g.kg-1.min-1维持,持续24～48 h。观察两组患者治疗后48 h、30 d MACE及出血并发症发生情况。结果:与对照组比较,观察组治疗后48 h和30 d,MACE发生率明显降低(2.12%对15.52%,10.63%对28.89%),差异有统计学意义(P<0.05),出血并发症仅见牙龈出血及皮肤出血点(分别为8例和6例)。结论:盐酸替罗非班可有效地减少老年NSTEMI患者MACE的发生率,改善预后,无严重出血并发症,具有较好的安全性。

Objective ： To investigate the occurrence and security of major adverse cardiovascular events （MACE） in the application of hydrochloride tirofiban in elderly patients with NSTEMI. Methods：92 elderly patients with NSTEMI who did not accept percutaneous coronary intervention （PCI） were selected in October 2009 to May 2012, aged 60 to 77 years old and randomly divided into the observation group （47 cases） and the controlled group （45 cases）. Besides the conventional drug treatment, the observation group were treated with hydrochloride tirofiban injection with an intravenous micro pump continuously pumping into the load of 0.4 mg. kg^- 1. min^-1, 30 min after 0.1 mg . kg^- 1 . min^- i, which sustained 24-48 hours. Such occurrences as cardiogenic sudden death, non-fatal myocardial infarction, recurrent angina, and bleeding complications were observed 48 hours and 30-day MACE after the treatment. Results：The MACE incidence was significantly lower 48 hours and 30 days after the treatment with tirofiban in the observation group than those of the con- trolled group （2.12% vs. 15.52%, 10.63% vs 28.89% ）. There was a statistically significant difference（P 〈 0.05）. Only some bleeding complications were found at gums （8 cases） and some skin points （6 cases）. Conclusion： Hydrochloride tirofiban effectively reduced the incidence of elderly patients with NSTEMI MACE and improved the outcome of their recovery with better security, but without any serious bleeding complications.