急性冠脉综合征合并糖尿病患者早期应用替罗非班的疗效和安全性评价.docVIP

·3073 · · 专 题 研 究 · 急性冠脉综合征合并糖尿病患者早期应用替罗非班的 疗效和安全性评价 汪亚芸，陈曼华，张利芸 【摘要】 目的 评价在阿司匹林、氯吡格雷、低分子肝素的基础上早期合用替罗非班治疗急性冠脉综合征合并 糖尿病的临床疗效和安全性。方法 选择2007年11月—2010年5月在我院住院的急性冠脉综合征合并糖尿病110例， 随机分成试验组(54例)和对照组(56例)。试验组患者在皮下注射低分子肝素的同时给予替罗非班静脉滴注；对照 组患者则单用低分子肝素8 d。观察两组治疗8d 内全因死亡、顽固性心肌缺血、再次心肌梗死的发生率，出血情况及 治疗前后血小板计数的变化。结果 试验组较对照组8d 内全因死亡、顽固性心肌缺血的发生率明显下降 (P0.05), 而两组再次心肌梗死的发生率间差异无统计学意义 (P0.05)。 两组患者均未出现严重出血，试验组内无出血35例， 轻度出血15例，中度出血4例；对照组无出血48例，轻度出血2例，中度出血6例，两组间差异有统计学意义 (u= 2.493,P0.05)。 试验组患者用药后血小板计数较用药前明显下降 (P0.05), 但均在正常范围内；与对照组比较 差异无统计学意义 (P0.05)。 结论 在阿司匹林、氯吡格雷、低分子肝素的基础上合用替罗非班治疗急性冠脉综合 征合并糖尿病有效且安全。 【关键词】 替罗非班；急性冠脉综合征；糖尿病；出血；治疗结果 【中图分类号】 R541.4 【文献标识码】 A 【文章编号】1007-9572(2011)09-3073-03 Ef fects and Safety of Tirofiban in Patients with Acute Coronary Syndrome and Complicated Diabetes WANG Ya -yun, CHEN Man-hua, ZHANG Li-yun. Department of Cardiology, Central Hospital of Wuhan, Wuhan 430014, China 【Abstract 】 Objective To evaluate the curative effects and safety of early tirofiban hydrochloride application on the ba- sis of aspirin,clopidogrel, and low molecular weight heparin(LMWH) treatment in patients with acute coronary syndrome com- plicated with diabetes. Methods A total of 110 cases of hospitalized patients with acute coronary syndrome accompanied by dia- betes were randomly divided into the study group (54 cases) and the control group (56 cases). Both groups received subcutane- ous LMWH for 8 days with the study group received additional intravenously injected tirofiban hydrochloride at the same time. Results Incidence rates of all-cause death and refractory angina pectoris during the 8 days of treatment were lower in the study group than in the control group(P0.05), while rates of recurrent myocardial infarction were not statistically different between the two groups(P0.05). No case of severe -hemorrage was observed for both groups; numbers of non -hemorrhage, mild - hemorrage,and moderate - hemorrage cases were found to be 35, 15, and 4 in the study group and