替罗非班与依诺肝素和阿司匹林合用在非ST段抬高急性冠脉综合征中应用探讨.docVIP

替罗非班与依诺肝素和阿司匹林合用在非ST段抬高急性冠脉综合征中应用探讨 　　[摘要] 目的:探讨替罗非班在非ST段抬高急性冠脉综合征中与依诺肝素和阿司匹林合用的有效性和安全性。方法:选择我院2006年8月～2008年8月确诊为非ST段抬高急性冠脉综合征患者121例,随机分为实验组和对照组,实验组在对照组的治疗基础上加用国产替罗非班,观察2 d、30 d时心血管事件的发生率。结果:实验组2 d、30 d的临床终点事件(包括死亡、新发心肌梗死、顽固性缺血即顽固性心绞痛)发生率与对照组比较显著降低,组间差异有统计学意义,且未见严重出血、血小板减少等并发症。结论:非ST段抬高的急性冠脉综合征患者在阿司匹林、依诺肝素治疗基础上加用替罗非班,临床应用效果显著,安全性较好,心脏事件发生率明显降低,值得临床推广。 　　[关键词] 急性冠脉综合征;替罗非班;心脏事件;血小板减少 　　[中图分类号] R54[文献标识码]A [文章编号]1673-7210(2010)01(b)-057-02 　　 　　The application of Tirofiban combined with Enoxaparin and Aspirine in non-ST segment elevation acute conoary syndrome 　　LIAO Weiguang, XIE Zhihuai 　　(Department of Cardiology, Leliu Hospital of Shunde District, Foshan 528322, China) 　　[Abstract] Objective: To investigate the efficacy and safety of Tirofiban combined with Enoxaparin and Aspirin on non-ST segment elevation acute conoary syndrome patients. Methods: 96 cases who confirmed non-ST segment elevation acute conoary syndrome from August 2006 to August 2008 were selected, they were randomly divided into test group and control group,Tirofiban were plus based on the control group observed the incidence of heart envent after 2 days and 30 days. Results: The incidence of the clinical end-point events (conclude death, new myocardial infarction, refractory ischemia namely refractory angina) in test group was obviously lower than the control group, and there was no serious hemorrhage and thrombocytopenia happen. Conclusion: There are significantly effects and better security on non-ST segment elevation acute conoary syndrome patients treated with Tirofiban combined with Enoxaparin and Aspirin, the incidence of heart envents are lower, well worth of clinical diffusion. 　　[Key words] Acute coronary syndrome; Tirofiban; Heart event; Thrombocytopenia 　　 　　非ST段抬高急性冠脉综合征包括非ST段抬高心肌梗死和不稳定心绞痛,其病理生理基础为斑块破裂、血栓不完全堵塞动脉或微栓塞,可伴有局灶性心肌梗死,治疗的原则是稳定病变,防止病变进展,减少死亡和发展至ST段抬高的心肌梗死的可能性,治疗的主要措施是积极抗血栓形成,抗缺血治疗。近期研究GPⅡb/Ⅲa受体拮抗剂对急性冠脉综合征疗效明显。现对我院2006年8月～2008年8月收治的121例患者报道如下: 　　1 资料与方法 　　1.1 一般资料