依折麦布联合替罗非班治疗急性冠脉综合征患者的疗效及对缺血修饰性白蛋白含量的影响

Therapeutic Efficacy of Ezetimibe Combined with Tirofiban in the Treatment of Acute Coronary Syndrome Patients and Its Influence on the Content of Ischemia Modified Albumin

目的:探讨依折麦布联合替罗非班治疗急性冠脉综合征患者的疗效及对外周血缺血修饰性白蛋白(IMA)含量的影响。方法:采用随机数字表法将我院2016年1月-2017年1月收治的82例急性冠脉综合征患者随机分配到观察组与对照组,每组41例,所有患者均给予他汀类及硝酸甘油等药物进行一般治疗。对照组患者另每日口服依折麦布片10 mg,每日1次;观察组患者在对照组基础上再静脉滴注盐酸替罗非班氯化钠注射液5 mg,每日1次,均连续给药15 d。评价两组患者临床疗效,比较治疗前和末次给药后两组患者硝酸甘油用量、心绞痛发作持续时间与发作频率、左心功能指标[每搏输出量(SV)、心脏左室舒张内径(LVDD)、每分输出量(CO)、射血分数(LVEF)],检测治疗前和第1天给药后3、6、9、12、15 h患者外周血IMA的含量,治疗期间密切观察两组患者出现的不良反应。结果:观察组总有效率为92.7%,明显高于对照组的73.2%(P<0.05)。与治疗前比较,末次给药后两组患者硝酸甘油用量和IMA含量(除对照组患者末次给药后3、6 h外)明显减少,心绞痛发作持续时间与发作频率明显缩短,SV、CO和LVEF明显增加,LVDD明显减小,且观察组效果明显优于对照组,以上差异均具有统计学意义(P<0.05)。治疗期间所有患者均未见发生严重不良反应。结论:在硝酸甘油一般治疗基础上,依折麦布联合替罗非班治疗急性冠脉综合征患者的疗效优于单用依折麦布,且可更快降低患者外周血IMA含量。

OBJECTIVE： To investigate therapeutic efficacy of ezetimibe combined with tirofiban in the treatment of acute coronary syndrome patients and its influence on the content of ischemia modified albumin （IMA） in peripheral blood. METHODS： A total of 82 patients with acute coronary syndrome in our hospital from Jan. 2016 to Jan. 2017 were divided into observe group and control group according to random number table, with 41 cases in each groups. All patients were given general treatment containing statins, glyceryl trinitrate and so on. Control group was additionally given Ezetimibe tablet 10 mg orally once a day. Observation group was additionally given Tirofiban hydrochloride sodium chloride injection 5 mg intravenously once a day, on the basis of con- trol group, for consecutive 15 d. Clinical efficacies of 2 groups were evaluated. The dose of glyceryl trinitrate, duration and fre- quency of angina pectoris attack, left ventricular function indexes （SV, LVDD, CO, LVEF） were compared before treatment and after last medication. The contents of IMA in peripheral blood were detected before treatment and 3, 6, 9, 12, 15 h after the first day medication. ADR of the 2 groups were observed closely during the treatment. RESULTS ： The total response rate of observation group was 92.7%, which was significantly higher than 72.3% of control group （P〈0.05）. Compared with before treatment, dose of glyceryl trinitrate and the content of IMA in 2 groups were decreased significantly after last medication, duration and frequencyof angina pectoris attack were shortened significantly; the levels of SV, CO and LVEF were increased significantly while the level of LVDD was decrease significantly; the effect of observation group was significantly better than that of control group, with statistical significance （P〈0.05）. No severe ADR was found in all patients during the treatment. CONCLUSIONS： Based on general treatment of glyceryl trinitrate therapeutic efficacy of ezetimibe combined with tirofiban is better than that of ezetimibe alone in the treatment acute coronary syndrome patients, and can decrease the content of IMA in peripheral blood more quickly.