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目的:观察小剂量替罗非班治疗高原非ST段抬高型急性冠脉综合征(NSTE-ACS)患者的疗效及安全性。方法:将75例NSTE-ACS患者随机分为对照组(n=37)和观察组(n=38)。两组均常规使用阿司匹林、氯吡格雷、低分子肝素等药物治疗,观察组加用小剂量替罗非班[负荷量0.3μg/(kg.min)×30 min,维持量0.05μg/(kg.min)×72 h]微量泵静脉泵入。检测治疗前后血小板计数和血小板聚集率;观察30 d内心血管事件和出血事件的发生率。结果:对照组30 d内心血管事件的发生率为22%,观察组为5%,两组间有显著差异(P<0.05);对照组30 d内出血事件的发生率为5%,观察组为8%,两组间无显著差异;对照组血小板聚集率治疗前后无显著变化,观察组治疗后血小板聚集率显著降低(P<0.05)。两组患者中均未观察到血小板减少的发生。结论:小剂量替罗非班联合阿司匹林、氯吡格雷和低分子肝素治疗高原NSTE-ACS是安全和有效的。
Objective: To observe the efficacy and safety of low-dose tirofiban in the treatment of patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS). Methods: Seventy-five patients with NSTE-ACS were randomly divided into control group (n = 37) and observation group (n = 38). Both groups were routinely treated with aspirin, clopidogrel, low molecular weight heparin and other drugs. The observation group was treated with low dose tirofiban [loading 0.3μg / (kg.min) × 30min, maintenance dose 0.05μg / (kg .min) × 72 h] micropump venous pump. The platelet count and platelet aggregation rate were measured before and after treatment. The incidence of cardiovascular events and bleeding events within 30 days were observed. Results: In the control group, the incidence of cardiovascular events within 30 days was 22% in the observation group and 5% in the observation group, with significant difference between the two groups (P <0.05). In the control group, the incidence of bleeding events within 30 days was 5% 8%, no significant difference between the two groups; control group platelet aggregation rate before and after treatment no significant change in the observation group after treatment, platelet aggregation was significantly reduced (P <0.05). No thrombocytopenia was observed in either group. CONCLUSIONS: Small doses of tirofiban in combination with aspirin, clopidogrel and LMWH are safe and effective in the treatment of high altitude NSTE-ACS.