替罗非班应用于不稳定型心绞痛及非Q波心肌梗死安全性及有效性.docVIP

替罗非班应用于不稳定型心绞痛及非Q波心肌梗死安全性及有效性 　 作者：陈珏，吴元，高润霖，乔树宾 【关键词】 替罗非班 【摘要】 目的 评价替罗非班在冠心病不稳定型心绞痛和非Q波心肌梗死中与肝素和阿司匹林合用的安全性和有效性。方法 为开放性国际多中心协作研究，我院共入选20例患者。结果 20例患者中男14例，女6例，平均年龄（53.2±7.3）岁。不稳定型心绞痛15例（75.0%），急性非Q波心肌梗死5例（25.0%），有陈旧性心肌梗死8例（40.0%），合并高血压患者8例(40.0%)，高脂血症8例(40.0%)，糖尿病4例(20.0%)，吸烟8例(40.0%)。用药后有 16例患者心绞痛不再发作，有效率达80.0%，其中4例(4/16,25.0%)在停用替罗非班后再发心绞痛。1例有消化道出血，1例有少量咯血，停用替罗非班好转。3例有皮下淤斑，位于输液部位。血红蛋白用药前后比较无明显变化（Pgt;0.05）。1例血小板计数于用药后减少至8.4万，停药后逐渐恢复至正常。停用替罗非班和肝素后 7 例患者施行冠状动脉搭桥术（CABG），4例施行PCI治疗，11例药物治疗。30天随访时无心肌梗死发生，死亡1例。结论 替罗非班在国人中用于不稳定型心绞痛和非Q波心肌梗死是安全和有效的，耐受性良好，无严重并发症发生，与阿司匹林和肝素合用未增加出血并发症。 　　【关键词】 替罗非班；不稳定型心绞痛；非Q波心肌梗死；安全性和有效性 　　Evaluation of the safety and efficacy of tirofiban in unstable angina and Non-Q wave myocardial infarction 　　【Abstract】 Objective To evaluate the safety and efficacy of tirofiban together with aspirin and heparin applied in patients with unstable anginal pectoris (UAP) and non-Q wave myocardial infarction(non-QWMI).Methods This is a multicenter international open trial including 20 patients with coronary artery disease on a domestic study.Results There were 20 cases in tirofiban clinical tral. 15 cases with unstable angina and 5 cases with non-QWMI, and 8 cases had OMI history.Risk factors:hypertention in 8 patients,diabetes mellitus in 4 patients, hyperlipoidemia in 8 cases,8 patients smoked for many years. Angina relieved in 16 patients after tirofiban injecting for 48 hours. All patients have no change in RBC and platelet account, where is no statistical significance before and after using tirofabin. 3 patients got ecchymosis under skin at injecting site.One Patient had hemoptysis, another one had melena. All patients didnt experience such adverse events as severe bleeding. At 30 days of follow-up, there were no MI, CABG or PTCA，but one dead(sudden death).Conclusion Tirofiban is safe and effect in Chinese patients with UAP and non-QWMI, there is no severe bleeding when tirofiban is applied with heparin and aspirin. 　　【Key words】 tirofiban；unstable angi