替罗非班治疗非血运重建老年急性冠状动脉综合征患者的临床疗效观察不同方案治疗手足外科难愈性伤口的疗效评价

Clinical effect of Tirofiba in the treatment of elderly patients with acute coronary syndrome

目的评价替罗非班对非血运重建的老年急性冠状动脉综合征患者(ACS)的疗效及安全性。方法选择84例老年ACS患者,随机分为对照组(n=42)和观察组(n=42),对照组行常规抗凝、抗血小板治疗,口服阿司匹林+氯吡格雷,观察组在对照组治疗的基础上加服替罗非班,比较两组抗血小板效果、肌钙蛋白(cTnT)变化、主要心血管不良事件及出血并发症。结果观察组治疗后的血小板聚集率和cTnT显著低于对照组(P<0.05),而活化部分凝血时间(APTT)显著高于对照组(P<0.05);观察组主要心血管不良事件,如死亡、心肌梗死、复发心绞痛和靶血管血运重建(TVR)均显著低于对照组;两组出血和血小板减少并发症率差异无统计学意义(P>0.05)。结论替罗非班能强化ACS标准治疗的抗凝、抗血小板效果,降低心血管不良事件及出血并发症,改善心肌细胞的损伤,疗效安全确切。

Objective To evaluate the clinical effect of Tirofiba in the treatment of elderly patients with acute coronary syndrome （ACS）.Methods Eighty-four elderly patients with ACS were randomly divided into the control group （n=42） and the observation group （n=42）.The control group was treated with routine anticoagulation,antiplatelet and oral aspirin＋clopidogrel.The observation group received oral Tirofiba based on the treatment of the control group.The antiplatelet effect,the variation of troponin （cTnT）,the major adverse cardiovascular events and bleeding complications between two groups were compared.Results The platelet aggregation rate and cTnT after treatment in the observation group was significantly lower than that of the control group （P＜ 0.05）,while the blood coagulation activation part time （APTT） was significantly higher than that of control group （P＜0.05）.The major adverse cardiovascular events,such as death,myocardial infarction,angina recurrence and TVR of target vessel revascularization in the observation group were significantly lower than that of the control group （P＜0.05）.The incidences of hemorrhage and thrombocytopenia showed statistically significant differences between the two groups （P＞0.05）.Conclusion Tirofiba could strengthen the anticoagulation and antiplatelet effective of the standard treatment for ACS,reduce the cardiovascular adverse events and bleeding complications,and improve the myocardial cell damage,with high curative effect and good safety.