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目的:探讨盐酸替罗非班对高危急性冠脉综合症(ACS)患者经封皮冠状动脉介入治疗(PCI)术前早期应用的疗效及安全性。方法:选择高危ACS患者195例、随机分为盐酸替罗非班实验组(n=98)和对照组97例,均于入选后72h内接受PCI治疗。比较两组间基础资料,记录使用盐酸替罗非班治疗期间的出血并发症和血小板减少症的发生率,随访术后30天内主要心血管事件(MACE)的发生率。结果:两组间基础临床资料无统计学差异;应用盐酸替罗非班组术后30天MACE发生率低于对照组(5.1%比8.2%);增龄(OR=1.362,P<0.001)、高血压(OR=5.254,P=0.042)和2型糖尿病(OR=11.542,P<0.001)是发生MACE的独立危险因素;在使用盐酸替罗非班的治疗期间、两组重度和轻度出血并发症的发生率差异无统计学意义,中度出血并发症和轻度血小板减少症发生率均为1.0%。结论:高危ACS患者早期介入治疗术前应用盐酸替罗非班是安全有效的,能及早强化抗血板治疗,有减少PCI术后MACE发生率的趋势。增龄、高血压和2型糖尿病是ACS患者中发生MACE的独立危险因素。
Objective: To investigate the efficacy and safety of tirofiban hydrochloride in the early preoperative application of percutaneous transluminal coronary angioplasty (PCI) in patients with high risk acute coronary syndrome (ACS). Methods: A total of 195 high-risk ACS patients were randomly divided into tirofiban hydrochloride group (n = 98) and control group (n = 98). All of them were received PCI within 72 hours after their enrollment. Baseline data were compared between the two groups and the incidence of bleeding complications and thrombocytopenia during treatment with tirofiban hydrochloride was recorded. The incidence of major cardiovascular events (MACE) within 30 days of follow-up was followed up. Results: There was no significant difference in the basic clinical data between the two groups. The incidence of MACE at 30 days after operation in the tirofiban group was lower than that in the control group (5.1% vs. 8.2%), and the age (OR = 1.362, P <0.001) Hypertension (OR = 5.254, P = 0.042) and type 2 diabetes (OR = 11.542, P <0.001) were independent risk factors for developing MACE. During the treatment with tirofiban hydrochloride, both severe and mild bleeding No significant difference in the incidence of complications, moderate bleeding complications and mild thrombocytopenia were 1.0%. CONCLUSION: Tirofiban hydrochloride is safe and effective before the interventional treatment in high-risk ACS patients. It can enhance anti-platelet therapy early and reduce the incidence of MACE after PCI. Age, hypertension, and type 2 diabetes mellitus are independent risk factors for MACE in patients with ACS.