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目的:观察替罗非班在非ST段抬高急性冠状动脉综合征(ACS)早期介入治疗的疗效。方法:将98例经危险度分层为高危险的非ST段抬高ACS患者行早期介入治疗,早期介入治疗指常规药物治疗24~48h后行冠状动脉介入治疗术(PCI),按就诊顺序分为替罗非班组和对照组。替罗非班组49例,于PCI前开始持续泵入替罗非班至术后36~48h。对照组49例,常规PCI。观察2组的急性或亚急性血栓闭塞事件发生率;进行6个月的随访,比较2组患者死亡、再次心肌梗死、心绞痛复发和再次血运重建术的发生率;监测术前、术后血小板活化度。结果:2组患者中无一例在住院期间死亡;替罗非班组无一例于术中或术后出现急性、亚急性血栓事件。对照组有2例患者术中出现急性血栓形成,2例出现亚急性血栓形成。随访6个月替罗非班组心脏不良事件发生率明显低于对照组(P<0.01),且不增加出血并发症。替罗非班组PCI后血小板活化度可明显降低(P<0.05)。结论:非ST段抬高ACS在常规药物治疗的基础上加用替罗非班,行早期PCI,可降低冠状动脉急性或亚急性血栓闭塞事件,改善患者的预后,同时不增加出血的风险。
Objective: To observe the effect of tirofiban in the early interventional treatment of non-ST segment elevation acute coronary syndrome (ACS). Methods: Ninety-eight non-ST-segment elevation ACS patients with high-risk stratification were enrolled in this study. Early interventional therapy was performed after 24-48 hours of conventional medical therapy and was followed up by PCI Divided into tirofiban group and control group. Forty-nine patients in the tirofiban group were enrolled in the tirofiban group until 36-48 hours after PCI. Control group, 49 cases, conventional PCI. The incidence of acute or subacute thrombo-occlusion events was observed in two groups. The patients were followed up for 6 months. The incidences of death, re-myocardial infarction, recurrence of angina pectoris and revascularization were compared between the two groups. The preoperative and postoperative platelets Degree of activation. Results: None of the 2 patients died during the hospital stay. None of the patients in the tirofiban group had acute or subacute thrombosis during or after surgery. In the control group, 2 patients developed acute thrombosis during operation and 2 patients developed subacute thrombosis. The incidence of adverse cardiac events in the nonflurane group was significantly lower than that in the control group (P <0.01) at 6 months follow-up, with no increase in bleeding complications. Tirofiban group platelet activation after PCI can be significantly reduced (P <0.05). Conclusion: The addition of tirofiban to non-ST-elevation ACS based on conventional medical therapy can reduce acute or sub-acute coronary thrombo-occlusive events and improve the prognosis of patients with coronary artery disease without increasing the risk of hemorrhage.