中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2015年
4期
269-272
,共4页
吾麦尔江·克力木%买买提艾力·吐尔逊
吾麥爾江·剋力木%買買提艾力·吐爾遜
오맥이강·극력목%매매제애력·토이손
冠状动脉疾病%血小板聚集抑制剂%手术中并发症%血管成形术,气囊,冠状动脉
冠狀動脈疾病%血小闆聚集抑製劑%手術中併髮癥%血管成形術,氣囊,冠狀動脈
관상동맥질병%혈소판취집억제제%수술중병발증%혈관성형술,기낭,관상동맥
Coronary diseases%Platelet aggregation inhibitors%Intraoperative complications%Angioplasty,balloon,coronary
目的 评价双联抗血小板基础上加用小剂量替罗非班在急性冠状动脉综合征冠状动脉支架植入术后应用的有效性和安全性.方法 入选2010年10月至2013年7月因急性冠状动脉综合征行经皮冠状动脉介入治疗(PCI)患者306例,根据临床用药的不同将所有患者分为三联组(156例)和双联组(150例).三联组术后在双联抗血小板基础上加用小剂量替罗非班,起始剂量0.4μg/(kg·min),30 min后0.1μg/(kg·min)维持24 ～ 36 h.双联组常规应用双联抗血小板治疗,观察两组术后出、凝血时间和血小板计数的改变,主要不良心血管事件(MACE)及出血事件的发生情况,评价其有效性及安全性.结果 双联组术后1周内发生支架内血栓3例(2.0％,3/150),行靶血管再通治疗4例(2.7％,4/150),三联组各发生1例(0.6％,1/156),两组比较差异均无统计学意义(P＞0.05).两组出血事件发生率比较差异无统计学意义(P＞0.05).两组术后出、凝血时间均有不同程度的延长,但两组比较差异无统计学意义(P＞0.05).结论 双联抗血小板基础上加用小剂量替罗非班治疗急性冠状动脉综合征PCI术后围手术期患者,可减少MACE的发生,不增加出血事件,相对安全有效.
目的 評價雙聯抗血小闆基礎上加用小劑量替囉非班在急性冠狀動脈綜閤徵冠狀動脈支架植入術後應用的有效性和安全性.方法 入選2010年10月至2013年7月因急性冠狀動脈綜閤徵行經皮冠狀動脈介入治療(PCI)患者306例,根據臨床用藥的不同將所有患者分為三聯組(156例)和雙聯組(150例).三聯組術後在雙聯抗血小闆基礎上加用小劑量替囉非班,起始劑量0.4μg/(kg·min),30 min後0.1μg/(kg·min)維持24 ～ 36 h.雙聯組常規應用雙聯抗血小闆治療,觀察兩組術後齣、凝血時間和血小闆計數的改變,主要不良心血管事件(MACE)及齣血事件的髮生情況,評價其有效性及安全性.結果 雙聯組術後1週內髮生支架內血栓3例(2.0％,3/150),行靶血管再通治療4例(2.7％,4/150),三聯組各髮生1例(0.6％,1/156),兩組比較差異均無統計學意義(P＞0.05).兩組齣血事件髮生率比較差異無統計學意義(P＞0.05).兩組術後齣、凝血時間均有不同程度的延長,但兩組比較差異無統計學意義(P＞0.05).結論 雙聯抗血小闆基礎上加用小劑量替囉非班治療急性冠狀動脈綜閤徵PCI術後圍手術期患者,可減少MACE的髮生,不增加齣血事件,相對安全有效.
목적 평개쌍련항혈소판기출상가용소제량체라비반재급성관상동맥종합정관상동맥지가식입술후응용적유효성화안전성.방법 입선2010년10월지2013년7월인급성관상동맥종합정행경피관상동맥개입치료(PCI)환자306례,근거림상용약적불동장소유환자분위삼련조(156례)화쌍련조(150례).삼련조술후재쌍련항혈소판기출상가용소제량체라비반,기시제량0.4μg/(kg·min),30 min후0.1μg/(kg·min)유지24 ～ 36 h.쌍련조상규응용쌍련항혈소판치료,관찰량조술후출、응혈시간화혈소판계수적개변,주요불양심혈관사건(MACE)급출혈사건적발생정황,평개기유효성급안전성.결과 쌍련조술후1주내발생지가내혈전3례(2.0％,3/150),행파혈관재통치료4례(2.7％,4/150),삼련조각발생1례(0.6％,1/156),량조비교차이균무통계학의의(P＞0.05).량조출혈사건발생솔비교차이무통계학의의(P＞0.05).량조술후출、응혈시간균유불동정도적연장,단량조비교차이무통계학의의(P＞0.05).결론 쌍련항혈소판기출상가용소제량체라비반치료급성관상동맥종합정PCI술후위수술기환자,가감소MACE적발생,불증가출혈사건,상대안전유효.
Objective To evaluate the efficacy and safety of low-dose tirofiban combined with dual anti-platelet therapy in patients undergoing coronary stent implantation for acute coronary syndrome.Methods From October 2010 to July 2013,a total of 306 patients undergoing percutaneous coronary intervention (PCI) for acute coronary syndrome were enrolled and divided into 2 groups:triple anti-platelet group (156 patients) and dual anti-platelet group (150 patients).Patients in triple anti-platelet group received low-dose tirofiban with starting dose 0.4 μ g/(kg· min) and 0.1 μ g/(kg·min) after 30 min for 24-36 h on the basis of dual anti-platelet therapy.Patients in dual anti-platelet group only received dual anti-platelet therapy.Information of the bleeding time,the clotting time,the platelet count change,the major adverse cardiac events (MACE),bleeding events in both groups were observed and the efficacy and safety were evaluated.Results The rate of thrombus of stent and target vessel revascularization were 2.0％ (3/150) and 2.7％ (4/150) in dual anti-platelet group,0.6％ (1/156) and 0.6％ (1/156) in triple anti-platelet group,and there were no significant differences between two groups (P ＞ 0.05).There was no significant difference in the rate of bleeding events between two groups (P ＞ 0.05).The bleeding time and clotting time in two groups were extended at different degree,but there were no significant differences (P ＞ 0.05).Conclusions Additional use of low-dose tirofiban is effective and safe in patients undergoing coronary stent implantation for acute coronary syndrome.It could not only reduce the MACE rate but also improve the coronary blood flow.Moreover,it does not increase the bleeding events.
