替罗非班早期用于经皮冠状动脉介入治疗的疗效与安全性

Clinical efficacy and safety of tirofiban in the treatment of patients who received percutaneous coronary intervention

目的评价替罗非班在急诊经皮冠状动脉介入治疗(PCI)的疗效及安全性。方法急诊收治的行PCI术患者87例,随机分为试验组41例和对照组46例,在常规抗凝治疗基础上,试验组于PCI术前早期静脉推注替罗非班10 mg·kg-1,然后以0.15μg·kg-1·min-1持续泵入至术后36 h;对照组只于PCI术前常规抗凝治疗。观察2组患者术后主要不良心血管事件(MACE)、心肌酶指标及出血并发症。结果试验组MACE发生率为9.8%(4/41),显著低于对照组26.1%(12/46),差别有统计学意义(P<0.05);试验组术后24 h心肌酶显著低于对照组(P<0.05);2组患者出血并发症差别无统计学意义(P>0.05)。结论急诊PCI患者早期用替罗非班可显著降低MACE发生率,且不增加术后出血发生的风险。

Objective To evaluate the clinical efficacy and safety of tirofiban in the treatment of patients who received percutaneous coronary intervention（PCI）. Methods Eighty- seven patients with acute coro- nary syndrome treated with PCI were recruited from Feb 2011 to Sep 2013 prospectively. They were randomly divided into treatment group （n =41 ） and control group （n =46）. Based on the regular anticoagulant therapy, patients in the treatment group were given tirofiban 10 the early time of pre - PCI. And the major adverse cardiovascular events （MACE）, myocardial enzymes and complication of the two groups were observed in the two groups. Results The rate of MACE （9. 8%, 4/41 ） in treatment group were much lower than that in the control group （26. 1%, 12/46） （P 〈 0. 05 ）. The myocardial enzyme indicators of 24 hours after PCI was lower than that in the control group; but there was no difference in bleeding complications between the two groups （ P 〉 0. 05 ）. Conclusion MACE can be significantly decreased in patients who were treated with PCI by using tirofiban in the emergency department and tiro- fiban does not increase the risks to develop bleeding complications.