围手术期替罗非班应用对行DES置入老年冠心病患者出血、血小板减少及MACE发生风险的影响

Effect of tirofiban used in the perioperative period on hemorrhage,thrombocytopenia and MACE risks of elderly patients with coronary heart disease after DES implantation

目的:探讨替罗非班围手术期应用对行药物洗脱支架(DES)置入老年冠心病患者出血、血小板减少及主要不良心血管事件(MACE)发生风险的影响。方法:研究对象选取某院2011年1月-2015年6月收治行DES置入老年冠心病患者共200例,采用随机数字表法分为对照组(100例)和观察组(100例),分别在术后给予常规二联抗血小板方案单用和在此基础上加用替罗非班治疗,比较2组患者TIMI出血分级情况、血小板减少率及随访MACE发生率等。结果:2组患者TIMI出血分级情况比较差异无统计学意义(P>0.05);2组患者血小板减少率比较差异无统计学意义(P>0.05);同时观察组患者随访MACE发生率显著低于对照组,差异有统计学意义(P<0.05)。结论:替罗非班围手术期应用用于行DES置入老年冠心病患者可有效降低远期MACE发生风险,改善临床预后,且未导致术后出血和血小板减少情况加重。

OBJECTIVE To investigate the effect of tirofiban used in the perioperative period on hemorrhage,thrombocytopenia and MACE risks of elderly patients with coronary heart diseases after DES implantation. METHODS Two hundred elderly patients with coronary heart diseases after DES implantation were chosen from January 2011 to June 2015 in a hospital and randomly divided into2 groups including control group（ n = 100） receiving conventional bigeminy antiplatelet regimen and observation group（ n = 100） receiving tirofiban based on the therapy of control group. TIMI hemorrhage classification,platelet reduction rate and incidence of MACE during follow-up were compared between two groups. RESULTS No significant difference was observed in TIMI hemorrhage classes or platelet reduction rate between 2 groups（ all P 0. 05）. The incidence of MACE during follow-up in observation group was significantly lower than that in control group（ P 0. 05）. CONCLUSION Tirofiban used in the perioperative period can efficiently reduce long-term risk of MACE,improve clinical outcomes and do not result in serious postoperative hemorrhage or thrombocytopenia in elderly patients with coronary heart diseases after DES implantation.