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目的观察盐酸替罗非班治疗非ST段抬高急性冠脉综合征(NSTE-ACS)的临床疗效及安全性。方法入选不稳定型心绞痛及非ST段抬高心肌梗死患者164例,随机分为观察组(n=82)和对照组(n=82)。对照组给予阿司匹林、低分子肝素、氯吡格雷等常规治疗;观察组在常规治疗基础上加用盐酸替罗非班[静脉负荷量0.4μg/(kg.min),30 min后以0.1μg/(kg.min)维持,持续48～120 h]。观察两组患者治疗36 h及30d后的主要不良心血管事件(MACE)及不良反应的发生情况。结果观察组治疗36 h及30 d后的MACE发生率分别为:2.4%和6.1%对照组分别为:12.2%和18.5%,两组患者36 h及30 d MACE发生率差异均有统计学意义(P均<0.05)。观察组与对照组出血发生率分别为:9.8%、6.1%,差异无统计学意义(P>0.05)。两组均无严重的出血并发症及显著血小板减少。结论 NSTE-ACS患者在常规药物基础上联用盐酸替罗非班治疗可减少MACE的发生率,但增加轻微出血的发生率。
Objective To observe the clinical efficacy and safety of tirofiban hydrochloride in the treatment of non-ST segment elevation acute coronary syndrome (NSTE-ACS). Methods A total of 164 patients with unstable angina pectoris and non-ST-elevation myocardial infarction were randomly divided into observation group (n = 82) and control group (n = 82). The control group was given conventional therapy such as aspirin, low molecular weight heparin and clopidogrel. The observation group was given tirofiban hydrochloride (intravenous loading 0.4μg / (kg · min) (kg.min) to maintain for 48 ~ 120 h]. The incidence of major adverse cardiovascular events (MACE) and adverse reactions after 36 and 30 days of treatment in both groups were observed. Results The incidence of MACE in observation group after 36 and 30 days of treatment were 2.4% and 6.1%, respectively, which were 12.2% and 18.5% respectively. There was significant difference in MACE incidence between the two groups at 36 and 30 days (P <0.05). The incidence of bleeding in observation group and control group were 9.8% and 6.1%, respectively, with no significant difference (P> 0.05). There were no severe bleeding complications and significant thrombocytopenia in both groups. Conclusion NSTE-ACS patients treated with tirofiban hydrochloride combined with conventional drugs can reduce the incidence of MACE, but increase the incidence of mild bleeding.