中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2015年
16期
36-38
,共3页
冠脉介入%替罗非班%不稳定型心绞痛%TIMI 血流%肌钙蛋白
冠脈介入%替囉非班%不穩定型心絞痛%TIMI 血流%肌鈣蛋白
관맥개입%체라비반%불은정형심교통%TIMI 혈류%기개단백
Percutaneous coronary intervention%Tirofiban%Unstable angina pectoris%TIMI flow%Troponin
目的：探讨小剂量替罗非班在老年不稳定型心绞痛患者行冠脉介入治疗中的有效性及安全性。方法选取64例老年不稳定型心绞痛择期行 PCI 患者，随机将其分为治疗组（35例）和常规组（29例），两组患者均给予常规药物治疗，治疗组在常规治疗的基础上行 PCI 术中加用替罗非班，术中冠脉内0.5μg/ kg，术后0.05μg/（kg·min）静脉滴注维持24 h；比较两组术后冠脉 TIMI 血流、肌钙蛋白（TnI）水平及住院期间、出院30 d心血管事件与出血事件发生率。结果冠脉介入术后治疗组慢血流的发生率低于常规组，差异有统计学意义（P ﹤0.05）；术后24 h TnI 两组均有升高，常规组升高幅度更显著，差异有统计学意义（P ﹤0.05）；住院期间及出院30 d随访，心绞痛症状再发率治疗组低于常规组，差异有统计学意义（P ﹤0.05）；两组术后出血事件发生率比较差异未见统计学意义（P ﹥0.05）。结论小剂量替罗非班在老年不稳定型心绞痛行择期 PCI 治疗中能有效改善心肌灌注，减少心肌损伤，改善心功能，减少不良心血管事件的发生，不增加出血风险。
目的：探討小劑量替囉非班在老年不穩定型心絞痛患者行冠脈介入治療中的有效性及安全性。方法選取64例老年不穩定型心絞痛擇期行 PCI 患者，隨機將其分為治療組（35例）和常規組（29例），兩組患者均給予常規藥物治療，治療組在常規治療的基礎上行 PCI 術中加用替囉非班，術中冠脈內0.5μg/ kg，術後0.05μg/（kg·min）靜脈滴註維持24 h；比較兩組術後冠脈 TIMI 血流、肌鈣蛋白（TnI）水平及住院期間、齣院30 d心血管事件與齣血事件髮生率。結果冠脈介入術後治療組慢血流的髮生率低于常規組，差異有統計學意義（P ﹤0.05）；術後24 h TnI 兩組均有升高，常規組升高幅度更顯著，差異有統計學意義（P ﹤0.05）；住院期間及齣院30 d隨訪，心絞痛癥狀再髮率治療組低于常規組，差異有統計學意義（P ﹤0.05）；兩組術後齣血事件髮生率比較差異未見統計學意義（P ﹥0.05）。結論小劑量替囉非班在老年不穩定型心絞痛行擇期 PCI 治療中能有效改善心肌灌註，減少心肌損傷，改善心功能，減少不良心血管事件的髮生，不增加齣血風險。
목적：탐토소제량체라비반재노년불은정형심교통환자행관맥개입치료중적유효성급안전성。방법선취64례노년불은정형심교통택기행 PCI 환자，수궤장기분위치료조（35례）화상규조（29례），량조환자균급여상규약물치료，치료조재상규치료적기출상행 PCI 술중가용체라비반，술중관맥내0.5μg/ kg，술후0.05μg/（kg·min）정맥적주유지24 h；비교량조술후관맥 TIMI 혈류、기개단백（TnI）수평급주원기간、출원30 d심혈관사건여출혈사건발생솔。결과관맥개입술후치료조만혈류적발생솔저우상규조，차이유통계학의의（P ﹤0.05）；술후24 h TnI 량조균유승고，상규조승고폭도경현저，차이유통계학의의（P ﹤0.05）；주원기간급출원30 d수방，심교통증상재발솔치료조저우상규조，차이유통계학의의（P ﹤0.05）；량조술후출혈사건발생솔비교차이미견통계학의의（P ﹥0.05）。결론소제량체라비반재노년불은정형심교통행택기 PCI 치료중능유효개선심기관주，감소심기손상，개선심공능，감소불양심혈관사건적발생，불증가출혈풍험。
Objective To study the efficacy and safety of small dose of tirofiban in elderly patients with unstable angina who underwent primary percutaneous coronary intervention. Methods Sixty-four elderly patients with unstable an-gina underwent elective PCI were randomly divided into treatment group(35 cases)and normal group(29 cases). The pa-tients of two groups were given routine drug therapy,in treatment group,on the basis of conventional treatment,tirofiban was used for PCI:5 μg/ kg bolus then 0. 05 μg/(kg·min)infusion for 24 h. The postoperative coronary TIMI flow,tropo-nin levels,and the incidence of cardiovascular events and bleeding events during hospitalization and discharge for 30 days were compared between the two groups. Results The incidence of slow blood flow in treatment group was lower than that in the normal group after PCI(P ﹤0. 05). TnI after 24 hours increased in both groups,that in the normal group rised more prom-inent(P ﹤0. 05). Hospitalization and follow-up in 30 days,discharge angina symptom recurrence rate in treatment group was less than that in the normal group(P ﹤0. 05). There was no significant difference in the incidence of bleeding events between the two groups(P ﹤0. 05). Conclusions Small doses of tirofiban in elderly patients with unstable angina underwent elective PCI can effectively improve myocardial perfusion,reduce myocardial injury,reduce the occurrence of adverse cardiovascular events,without increasing the risk of bleeding.
