中国循证心血管医学杂志
中國循證心血管醫學雜誌
중국순증심혈관의학잡지
CHINESE JOURNAL OF EVIDENCE-BASES CARDIOVASCULAR MEDICINE
2015年
3期
368-370
,共3页
急性冠状动脉综合征%替罗非班%安全性%有效性
急性冠狀動脈綜閤徵%替囉非班%安全性%有效性
급성관상동맥종합정%체라비반%안전성%유효성
Acute coronary syndrome%Tirofiban%Safety%Efficacy
目的:探讨替罗非班注射液治疗急性冠脉综合征(ACS)的临床有效性和安全性。方法选取2011年10月至2013年4月期间揭阳市人民医院心血管内科诊治的ACS患者92例,其中男性61例,女性31例,年龄52~74岁,平均年龄(62.8±7.3)岁。随机分为对照组和治疗组,各46例。对照组给予阿司匹林、低分子肝素、氯吡格雷、阿托伐他汀等常规药物治疗,治疗组在对照组基础上再给予替罗非班。分析比较两组患者治疗24 h后心肌肌钙蛋白I(cTnI)峰值水平、治疗30 d后主要不良心血管事件、ST段回落率、左室射血分数(LVEF)及出血情况。结果两组治疗后与治疗前比较cTnI均升高;治疗组较对照组治疗后cTnI降低[(1.54±0.52)μg/L vs.(2.24±0.48)μg/L],差异有显著统计学意义(P均<0.01)。对照组较治疗组主要不良心血管事件总发生率升高(15.22%vs.2.17%),差异有统计学意义(P<0.05)。对照组25例心电图ST段回落,回落率为54.35%,治疗组37例回落,回落率为80.43%,组间比较差异有显著统计学意义(P<0.01)。两组患者治疗30 d后,LVEF均高于治疗前,差异有显著统计学意义(P均<0.01)。治疗组治疗后LVEF高于对照组[(58.1±5.6)%vs.(46.2±5.1)%],有显著统计学差异(P<0.01)。皮肤及黏膜出血对照组10例,发生率21.74%,治疗组7例,发生率15.22%,组间比较差异无统计学意义(P>0.05)。结论常规治疗基础上增加替罗非班治疗ACS可有效减低心肌细胞损伤和心脏不良事件发生率,改善心功能,安全性好。
目的:探討替囉非班註射液治療急性冠脈綜閤徵(ACS)的臨床有效性和安全性。方法選取2011年10月至2013年4月期間揭暘市人民醫院心血管內科診治的ACS患者92例,其中男性61例,女性31例,年齡52~74歲,平均年齡(62.8±7.3)歲。隨機分為對照組和治療組,各46例。對照組給予阿司匹林、低分子肝素、氯吡格雷、阿託伐他汀等常規藥物治療,治療組在對照組基礎上再給予替囉非班。分析比較兩組患者治療24 h後心肌肌鈣蛋白I(cTnI)峰值水平、治療30 d後主要不良心血管事件、ST段迴落率、左室射血分數(LVEF)及齣血情況。結果兩組治療後與治療前比較cTnI均升高;治療組較對照組治療後cTnI降低[(1.54±0.52)μg/L vs.(2.24±0.48)μg/L],差異有顯著統計學意義(P均<0.01)。對照組較治療組主要不良心血管事件總髮生率升高(15.22%vs.2.17%),差異有統計學意義(P<0.05)。對照組25例心電圖ST段迴落,迴落率為54.35%,治療組37例迴落,迴落率為80.43%,組間比較差異有顯著統計學意義(P<0.01)。兩組患者治療30 d後,LVEF均高于治療前,差異有顯著統計學意義(P均<0.01)。治療組治療後LVEF高于對照組[(58.1±5.6)%vs.(46.2±5.1)%],有顯著統計學差異(P<0.01)。皮膚及黏膜齣血對照組10例,髮生率21.74%,治療組7例,髮生率15.22%,組間比較差異無統計學意義(P>0.05)。結論常規治療基礎上增加替囉非班治療ACS可有效減低心肌細胞損傷和心髒不良事件髮生率,改善心功能,安全性好。
목적:탐토체라비반주사액치료급성관맥종합정(ACS)적림상유효성화안전성。방법선취2011년10월지2013년4월기간게양시인민의원심혈관내과진치적ACS환자92례,기중남성61례,녀성31례,년령52~74세,평균년령(62.8±7.3)세。수궤분위대조조화치료조,각46례。대조조급여아사필림、저분자간소、록필격뢰、아탁벌타정등상규약물치료,치료조재대조조기출상재급여체라비반。분석비교량조환자치료24 h후심기기개단백I(cTnI)봉치수평、치료30 d후주요불양심혈관사건、ST단회락솔、좌실사혈분수(LVEF)급출혈정황。결과량조치료후여치료전비교cTnI균승고;치료조교대조조치료후cTnI강저[(1.54±0.52)μg/L vs.(2.24±0.48)μg/L],차이유현저통계학의의(P균<0.01)。대조조교치료조주요불양심혈관사건총발생솔승고(15.22%vs.2.17%),차이유통계학의의(P<0.05)。대조조25례심전도ST단회락,회락솔위54.35%,치료조37례회락,회락솔위80.43%,조간비교차이유현저통계학의의(P<0.01)。량조환자치료30 d후,LVEF균고우치료전,차이유현저통계학의의(P균<0.01)。치료조치료후LVEF고우대조조[(58.1±5.6)%vs.(46.2±5.1)%],유현저통계학차이(P<0.01)。피부급점막출혈대조조10례,발생솔21.74%,치료조7례,발생솔15.22%,조간비교차이무통계학의의(P>0.05)。결론상규치료기출상증가체라비반치료ACS가유효감저심기세포손상화심장불량사건발생솔,개선심공능,안전성호。
Objective To investigate the efficacy and safety of tirofiban in treatment of acute coronary syndrome (ACS). Methods ACS patients (n=92, male 61, female 31, aged from 52 to 74 and average age=62.8± 7.3) were chosen from Oct. 2011 to Apr. 2013, and randomly divided into control group and treatment group (each n=46). The control group and treatment group were given routine drugs including aspirin, low molecular weight heparin, clopidogrel and atorvastatin, and treatment group was additionally given tirofiban. The peak level of cardiac troponin I (cTnI) after treatment for 24 h, and major adverse cardiovascular events (MACE), ST-segment resolution rate, LVEF and bleeding events after treatment for 30 d were compared between 2 groups. Results The level of cTnI increased in 2 groups after treatment, and was lower in treatment group than that in control group [(1.54 ±0.52)μg/L vs. (2.24±0.48)μg/L, all P<0.01]. The incidence of MACE increased in control group compared with treatment group (15.22%vs. 2.17%, P<0.05). There were 25 cases with ST-segment resolution and resolution rate was 54.35%in control group, and there were 37 cases with ST-segment resolution and resolution rate was 80.43%(P<0.01). After treatment for 30 d, LVEF was higher in 2 groups than before (all P<0.01), and was higher in treatment group than that in control group [(58.1±5.6)% vs. (46.2±5.1)%, P<0.01]. There were 10 cases (21.74%) with skin and mucous membrane bleeding in treatment group and 7 (15.22%) in control group (P>0.05). Conclusion Routine therapy combining tirofiban in treatment of ACS can relieve myocardial cell injury, reduce incidence of MACE and improve heart function with higher safety.