替罗非班在急性冠脉综合征患者术前 不同时期应用临床价值分析.docVIP

替罗非班在急性冠脉综合征患者术前 不同时期应用临床价值分析 　　[摘要] 目的 探讨替罗非班（tirofiban）在急诊PCI（percutaneous coronary intervention，PCI）患者术前不同时期应用的临床价值。 方法 回顾性分析2010年8月～2013年11月四川省都江堰市人民医院急诊行PCI术患者98例，其中PCI术前急诊即开始应用替罗非班者47例（术前组），PCI术中应用者51例（术中组），分析两组患者PCI术后24h心肌酶CK-MB和cTNI 有无差别；两组患者术后主要心血管并发症有无差别。 结果 术前组PCI术后24h心肌酶显著低于术中组（t=3.09/2.66 , P＜0.05）；术前组患者术后主要心血管事件明显低于对照组（x2=4.01，P＜0.05）。 结论 急性冠脉综合征患者术前急诊早期应用替罗非班可降低患者不良心血管事件的发生风险，改善心肌酶指标。 　　[关键词] 替罗非班；急性冠脉综合征；临床疗效 　　[中图分类号] R541.4#8195;#8195;#8195;[文献标识码] B#8195;#8195;#8195;[文章编号] 2095-0616（2014）09-97-03 　　 　　Clinical efficacy of tirofiban usage in different period of time before surgery for patients with PCI 　　LI#8195;Bin 　　Department of Cardiology,Dujiangyan Traditional Chinese Medicine Hospita,Dujiangyan 611830,China 　　[Abstract] Objective To evaluate the clinical efficacy of tirofiban in different period of time before surgery for patients with acute coronary syndrome who received PCI. Methods 98 patients from Aug 2010 to Nov 2013 with acute coronary syndrome treated with PCI were analyzed respectively in the department of emergency in the Peoples Hospital of Dujiangyan. Of the included 98 subjects 47 patients treated by tirofiban prior the PCI(treatment group) and 51 cases treated by tirofiban intra the PCI(control group). And the major cardiovascular events and the CK-MB, cTNM was compared between the two groups. Results The enzyme in the preoperative group of PCI was significantly lower than that in the intraoperative group (t=3.09/2.66, P＜0.05);The major cardiovascular events and cardiac enzymes in treatment group was much lower than that in the control group(x2=4.01，P＜0.05). Conclusion Application tirofiban as early as possible can significantly decrease the major cardiovascular risk and protect the heart muscle. 　　[Key words] Tirofiban; Acute coronary syndrome; Clinical efficacy 　　急性冠脉综合征（acute coronary syndrome，ACS）是急诊最为常见的心血管急症之一，如抢救治疗不及时预后较差[1]。经皮穿刺冠脉成形术是治疗ACS的重要方法，可以及时挽救濒临死亡的心肌，提高患者术后生活质量，提高预后。替罗非班为血小板糖蛋白受体拮抗剂，能阻断血小板粘附聚集相关通路，抑制血小板