摘要
目的探讨小剂量盐酸替罗非班在急性冠脉综合征(ACS)药物保守治疗中的安全性及有效性。方法选择105例采用药物保守治疗的ACS患者,按就诊顺序分为观察组(53例)及对照组(52例),两组均常规使用阿司匹林、低分子肝素、氯吡格雷药物等治疗,观察组加用小剂量替罗非班静脉滴注,起始剂量为前30min 0.2μg/(kg·min),后以0.05μg/(kg·min)持续静脉滴注72h,比较两组治疗效果及不良反应。结果与对照组比较,用药后7d及30d观察组复合心血管事件(顽固性心绞痛+再发心肌梗死+死亡)的发生率降低了3.92%和7.7%,顽固性心绞痛的发生率降低了3.92%和9.69%,再发心肌梗死的发生率降低了5.80%和7.73%,死亡率均降低了1.92%;观察组血小板聚集率降低更明显(P<0.01)。观察组和对照组主要不良事件均为出血,发生率分别为9.43%和7.69%(P>0.05)。结论在ACS药物保守治疗中,小剂量替罗非班能有效抗血小板聚集且不增加出血风险,与肝素及阿司匹林、氯吡格雷合用治疗ACS是安全有效的。
Objective To investigate the safety and effectiveness of low- dose tirofiban hydrochloride in the conservative treatment of acute coronary syndrome （ACS）. Methods The selected 105 cases of ACS treated with drug conservative treatment, according to treatment sequence, were divided into the tirofiban group（53 cases） and the control group（52 cases）. Both groups were routinely used the drug treatment of aspirin, low molecular weight heparin and clopidogrel. The tirofiban group was added low dose tirofiban after 3 d of admission to hospital on the basis of conventional drug therapy, the starting dose was infused with 0. 2 μg/（kg · min） for 30 min, then infused intravenously with 0. 05 μg/（kg · min） for 72 h. To compared the efficacy and adverse reactions between the two groups. Results Compared with the control group, after 7 d and 30 d, the incidence of composite cardiovascular events（refractory angina pectoris, Myocardial Infarction, death） in the tirofiban group was lowered by 3.92% and 7.7%, the incidence of refractory angina pectoris was lowered by 3.92% and 9.69%, the incidence of recurrent MI was lowered by 5.80% and 7.73%, the incidence of mortality rate was lowered by 1.92% and 1.92%, （ P 〈 0.05）. The tirofiban group could significantly reduce the platelet aggregation rate, had more effects than the control group （P〈0.01）.The main adverse events of the two groups were bleeding, the rates were 9.43%, 7.69% （P〉0.05）. Conclusion In the patients with ACS treated with the conservative treatment, low dose tirofiban can be effectively against platelet aggregation without increasing bleeding risk. Combination of heparin, aspirin and clopidogrel hydrogen is safe and effective.
出处
《中国药业》
CAS
2010年第7期12-13,共2页
China Pharmaceuticals
