【摘要】 目的评价国产替罗非班对老年(≥60岁)急性冠脉综合征(ACS)接受冠状动脉介入治疗(PCI)患者近期预后的影响。方法 325例患者根据是否使用替罗非班分为替罗非班组(n=210)和对照组(n=115),所有患者术中均植入了药物洗脱支架;替罗非班组在口服阿司匹林+氯吡格雷基础上加用替罗非班,对照组仅口服阿司匹林+氯吡格雷;比较两组基线资料、支架植入即刻心肌梗死溶栓治疗(TIMI)血流3级比率、支架内血栓发生率、轻微出血、大出血和血小板减少发生率、术后30 d死亡、心肌梗死(MI)和靶血管血运重建(TVR)率。结果替罗非班组PCI后即刻TIMI血流3级比率高于对照组(99.05%vs 94.78%,P<0.05);支架内血栓发生率明显低于对照组(0.47%vs3.47%,P<0.01);术后30 d,替罗非班组死亡、MI和TVR率明显低于对照组(分别为0.00%vs 2.61%、0.47%vs 3.47%和0.47%vs 1.73%,P<0.01);替罗非班组轻微出血发生率高于对照组,但无统计学差异(7.14%vs4.35%,p>0.05),两组大出血发生率和血小板减少发生率均无显著差异(分别为0.00%vs 0.00%和0.95%vs 0.87%,P>0.05)。结论国产替罗非班可明显改善老年ACS患者PCI术后即刻TIMI血流状况;有效降低支架内血栓发生率;减少术后30 d死亡、MI和TVR发生率,且不增加大出血和血小板减少的发生,从而改善患者的近期预后。更多还原

【Abstract】 Objective To evaluate the effect of tirofiban on short-term prognosis of elderly patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention(PCI).Methods Totally 325 ACS patients were divided into two groups: Tirofiban group(n = 210) and control group(n= 115).All subjects underwent PCI with drug-eluting stents.Patients in tirofiban group received tirofiban,in addition to aspirin and clopidogrel.Patients in control group received oral administration of aspirin and clopi-dogrel only.The general data,the rate of thrombolysis in myocardial infarction(TIMI) grade 3 flow immediately after PCI,the in-stent thrombosis incidence,mild and severe bleeding rate,platelet decrease rate,mortality,and incidences of myocardial infarction (MI) and target vessel revascularization(TVR) at 30 days after PCI were compared between the two groups.Results The rate of TIMI grade 3 flow immediately after PCI was significantly higher in Tirofiban group than in control group(99.05%vs 94.78%,P<0.05).The in-stent thrombosis incidence was lower in Tirofiban group than in control group(0.47%vs 3.47%,P<0.01).The mortality and incidences of MI and TVR at 30 days after PCI were lower in Tirofiban group than in control group(0.00%vs 2.61%,0.47%vs 3.47%,and 0.47%vs 1.73%,P<0.01).The mild bleeding rate was higher in Tirofiban group than in control group,with no significant difference(7.14%vs 4.35%,P>0.05).The rates of severe bleeding and platelets decrease were not significantly different between the two groups(0.00%vs 0.00%,and 0.95%vs 0.87%,P>0.05).Conclusion Tirofiban can improve the TIMI grade flow in elderly patients with ACS after PCI.It can also decrease the in-stent thrombosis incidence,mortality,and incidences of MI and TVR at 30 days after PCI,but do not increase the rates of severe bleeding and platelets decrease in these patients.So it can improve the short-term prognosis in elderly patients with ACS undergoing PCI.更多还原