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目的:观察替若非班注射液治疗无血运重建的老年急性心肌梗死患者的临床疗效及其安全性。方法:选择病例为急性心肌梗死老年患者共105例,其中常规治疗组56例,替若非班组49例。两组均按治疗原则进行,给予抗血小板(阿司匹林、氯吡格雷),抗凝,ACEI或ARB,β-受体阻滞剂,他汀类药物等,替若非班组在上述治疗基础上,加用替若非班注射液加强抗血小板治疗。观察急性期(1周内)两组主要心血管终点、转归及出血风险的发生,同时,抽血检测血清CK-MB和cTNI。结果:与常规治疗组相比,替若非班组在主要心血管终点(心源性猝死/再发急性心肌梗死)方面均有所降低(P<0.05),7 d后转归情况也优于常规治疗组(P<0.05),而出血风险两组差异无统计学意义(P>0.05);两组患者在发病24 h和72 h心肌坏死标志物CK-MB和cTNI比较,替若非班组心肌坏死标志物下降明显(P<0.05)。结论:替若非班注射液治疗无血运重建的老年急性心肌梗死患者的临床疗效肯定,出血的风险与常规治疗组无统计学差异,显示其良好的安全性。
Objective: To observe the clinical efficacy and safety of Tirofiban injection in elderly patients with acute myocardial infarction without revascularization. Methods: A total of 105 cases of elderly patients with acute myocardial infarction were selected, including 56 cases in the conventional treatment group and 49 cases in the non-arm control group. The two groups were treated according to the principle of treatment, given anti-platelet (aspirin, clopidogrel), anticoagulant, ACEI or ARB, β-blockers, statins and other non-team on the basis of the above treatment, plus For non-class injection to enhance anti-platelet therapy. During the acute phase (within 1 week), the main cardiovascular endpoints, outcome and the risk of bleeding were observed. At the same time, serum CK-MB and cTNI were detected by blood sampling. RESULTS: Tirofiban group had a lower (P <0.05) decrease in major cardiovascular end points (sudden cardiac death / recurrent AMI) compared with the conventional treatment group, and also better than conventional Treatment group (P <0.05), while there was no significant difference in bleeding risk between the two groups (P> 0.05). Compared with CK-MB and cTNI, markers of myocardial necrosis 24 h and 72 h after onset in both groups, The markers decreased significantly (P <0.05). CONCLUSION: The clinical efficacy of Ruoriban injection in the treatment of senile patients with acute myocardial infarction without revascularization is affirmed that the risk of bleeding is not statistically different from that of the conventional treatment group, indicating its good safety.