中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2009年
8期
826-830
,共5页
何胜虎%袁彬%陈述%张薏%张晶%燕建峰%谢勇%刘晓东%孙磊%徐日新%顾翔%屠莉莉%马根山
何勝虎%袁彬%陳述%張薏%張晶%燕建峰%謝勇%劉曉東%孫磊%徐日新%顧翔%屠莉莉%馬根山
하성호%원빈%진술%장의%장정%연건봉%사용%류효동%손뢰%서일신%고상%도리리%마근산
急性冠状动脉综合征%替罗非班%主要心血管事件%TIMI分级%校正的TIMI计帧数%心肌Blush分级%有效性%安全性%老年患者
急性冠狀動脈綜閤徵%替囉非班%主要心血管事件%TIMI分級%校正的TIMI計幀數%心肌Blush分級%有效性%安全性%老年患者
급성관상동맥종합정%체라비반%주요심혈관사건%TIMI분급%교정적TIMI계정수%심기Blush분급%유효성%안전성%노년환자
Acute coronary syndromes%Tirofiban%Major adverse cardiac events%TIMI grade%corrected TIMI flame count%Myocardial blush grade%Safety%Efficacy%Elderly patients
目的 评价老年急性冠状动脉综合征(ACS)患者应用替罗非班的有效性和安全性.方法 选择2006年12月至2008年6月在苏北人民医院住院的老年ACS患者106例进行前瞻性随机对照研究,根据是否行PCI分为PCI组和药物保守治疗组,两组患者再随机分为替罗非班治疗业组和常规治疗亚组,PCI组术前给予负荷量替罗非班10 μg·kg-1,3 min内静脉注射完毕,继而以0.15 μg·kg-1·min-1持续泵入24～36 h.药物保守治疗组(负荷量0.4 μg·kg-1·min-1× 30 min,维持量0.1 μg·kg-1·min-1×48 h).采用成组t检验和方差分析法(ANOVA)分析比较各亚组间住院期间及随访30 d主要心血管事件(死亡、新的心肌梗死和顽固性心肌缺血)的发生率、出血的发生率及PCI治疗组术后TIMI分级、校正的TIMI计帧数(CTFC)及心肌Blush分级(MBG).结果 各亚组间一般资料相似,药物保守治疗组中替罗非班亚组随访30 d MACE发生率较常规治疗亚组显著降低(12.0%vs.36.4%;P<0.05),PCI治疗组中替罗非班亚组CTFC低于常规治疗亚组[(23.5±5.1)帧和(31.4±5.2)帧,P<0.01],Blush 3级获得率明显高于常规治疗亚组(64.3%和29.0%,P<0.01).出血发生率两组无统计学意义(P>0.05).结论 老年ACS患者使用替罗非班具有更好的血流及心肌灌注,减少缺血事件发生,且安全性好.
目的 評價老年急性冠狀動脈綜閤徵(ACS)患者應用替囉非班的有效性和安全性.方法 選擇2006年12月至2008年6月在囌北人民醫院住院的老年ACS患者106例進行前瞻性隨機對照研究,根據是否行PCI分為PCI組和藥物保守治療組,兩組患者再隨機分為替囉非班治療業組和常規治療亞組,PCI組術前給予負荷量替囉非班10 μg·kg-1,3 min內靜脈註射完畢,繼而以0.15 μg·kg-1·min-1持續泵入24～36 h.藥物保守治療組(負荷量0.4 μg·kg-1·min-1× 30 min,維持量0.1 μg·kg-1·min-1×48 h).採用成組t檢驗和方差分析法(ANOVA)分析比較各亞組間住院期間及隨訪30 d主要心血管事件(死亡、新的心肌梗死和頑固性心肌缺血)的髮生率、齣血的髮生率及PCI治療組術後TIMI分級、校正的TIMI計幀數(CTFC)及心肌Blush分級(MBG).結果 各亞組間一般資料相似,藥物保守治療組中替囉非班亞組隨訪30 d MACE髮生率較常規治療亞組顯著降低(12.0%vs.36.4%;P<0.05),PCI治療組中替囉非班亞組CTFC低于常規治療亞組[(23.5±5.1)幀和(31.4±5.2)幀,P<0.01],Blush 3級穫得率明顯高于常規治療亞組(64.3%和29.0%,P<0.01).齣血髮生率兩組無統計學意義(P>0.05).結論 老年ACS患者使用替囉非班具有更好的血流及心肌灌註,減少缺血事件髮生,且安全性好.
목적 평개노년급성관상동맥종합정(ACS)환자응용체라비반적유효성화안전성.방법 선택2006년12월지2008년6월재소북인민의원주원적노년ACS환자106례진행전첨성수궤대조연구,근거시부행PCI분위PCI조화약물보수치료조,량조환자재수궤분위체라비반치료업조화상규치료아조,PCI조술전급여부하량체라비반10 μg·kg-1,3 min내정맥주사완필,계이이0.15 μg·kg-1·min-1지속빙입24～36 h.약물보수치료조(부하량0.4 μg·kg-1·min-1× 30 min,유지량0.1 μg·kg-1·min-1×48 h).채용성조t검험화방차분석법(ANOVA)분석비교각아조간주원기간급수방30 d주요심혈관사건(사망、신적심기경사화완고성심기결혈)적발생솔、출혈적발생솔급PCI치료조술후TIMI분급、교정적TIMI계정수(CTFC)급심기Blush분급(MBG).결과 각아조간일반자료상사,약물보수치료조중체라비반아조수방30 d MACE발생솔교상규치료아조현저강저(12.0%vs.36.4%;P<0.05),PCI치료조중체라비반아조CTFC저우상규치료아조[(23.5±5.1)정화(31.4±5.2)정,P<0.01],Blush 3급획득솔명현고우상규치료아조(64.3%화29.0%,P<0.01).출혈발생솔량조무통계학의의(P>0.05).결론 노년ACS환자사용체라비반구유경호적혈류급심기관주,감소결혈사건발생,차안전성호.
Objective To evaluate the safety and efficacy of firofiban in gerontal patients with acute coronary syndrome(ACS). Method A total of 106 elderly patients with ACS admitted form December 2006 to June 2008 were enrolled in a prospective case-control study. Patients were divided into percutaneous coronary intervention (PCI) group and medicine group. Both groups were randomly divided into two sub-groups, tirofiban sub-group
and placebo sub-group. Patients in the PCI group received tirofiban infused in dose of 10 μg·kg- within 3 minutes
as loading dose before operation and then an infusion of 0.15μg'kg-1·min-1 as maintenance dose for 24～36 hours. In medicine group,the loading dose was 0.4 μg·kg-1·min-1×30 min and the maintaining dose was 0.1 μg·kg-1·min-1×48 hours, The rates of major adverse cardiac events (MACE) consisting of death, myocardial infarction or refractory ischemia during hospital stay stay and 30 days' follow-up, bleeding rates TIMI grade, corrected TIMI frame count (CTFC) and myocardial blush grade(MBG) after PCI were compared between sub-groups of PCI group. Results The basic clinical data were similar among the sub-groups. In medicine group,the MACE rate during 30 days' follow-up was much lower in the tirofiban sub-group than in the placebo sub-group (12.0% vs. 36.4 %, P < 0.05). In comparison with medicine group, in PCI group, there were fewer TIMI frames [(23.5 ±5.1) frames vs. (31.4±5.2) frames, P < 0.01] and higher percentage of myocardial blush grade 3(64.3% vs. 29.0%, P < 0.01) in firotiban sub-group of PCI group. No significant differences in bleeding rates were found between all sub-groups. Conclusions Tirofiban is safe and effective in gerontal ACS patients with blood flow and reperfusion improved.
