替罗非班联合瑞替普酶治疗急性心肌梗死安全性研究

Safety of reperfusion therapy with combination of tirofiban and half-dose reteplase in treating acute myocardial infarction

目的:探讨替罗非班联合半量瑞替普酶溶栓用于急性ST段抬高性心肌梗死治疗的安全性。方法:入选我院急性ST段抬高性心肌梗死患者208例,年龄27～75岁,随机分为联合溶栓组及瑞替普酶组。比较两组30 d内各种原因导致的死亡、心力衰竭或肺水肿、室性心动过速或心室颤动、非致死性再梗死、心肌缺血复发等临床事件发生率以及轻度出血、中度出血、严重出血及脑出血事件发生率。结果:两组患者死亡、心源性休克、心室颤动、II～III度房室传导阻滞、补救性PCI事件发生率无差异,联合溶栓组非致死性心肌再梗死发生率、心肌缺血、室性心动过速、心力衰竭及肺水肿发生率明显低于瑞替普酶组。两组轻度出血、中度出血、严重或威胁生命的出血及总出血发生率无差异。结论:替罗非班联合半量瑞替普酶溶栓用于急性心肌梗死治疗与瑞替普酶溶栓相比,安全性方面相似。

Objective： To investigate the safety of reperfusion therapy with combination of tirofiban and half-dose reteplase in the treatment of acute ST segment elevation myocardial infarction （STEMI）. Methods： To- tally 208 STEMI patients in our hospital were randomly assigned to the treatment of either half-dose reteplase com- bined with full-dose tirofihan or standard-dose reteplase alone. The incidence of death for various causes within 30 days, heart failure, cardiogenic shock, ventrieular tachycardia or ventrieular fibrillation, reinfarction, myocardial ischemia recurrence and hemorrhage between two groups were compared. Results： There was no difference in mor- tality between combined and reteplase alone groups, but in combined group the rates of recurrent myocardial infarc- tion, recurrent ischemia, ventricular tachycardia or fibrillation, and severe pump failure were fewer. There was no difference in rates of mild, moderate and life-threatening bleedings between two groups. Conclusion： The safety profile of reperfusion therapy with combination of tirofiban and half-dose reteplase for STEMI is similar to that of standard-dose reteplase.