论文部分内容阅读
目的探讨大剂量替罗非班在急性心肌梗死(AMI)介入治疗中的有效性和安全性。方法选取无锡市中医医院2008年6月—2012年8月收治的行经皮冠状动脉成形介入治疗(PCI)的AMI患者160例,按照入院顺序分为观察组与对照组,各80例。两组患者围术期其他药物治疗相同,在行冠状动脉造影前,对照组给予替罗非班常规剂量10μg/kg治疗,观察组给予替罗非班大剂量20μg/kg治疗,之后两组患者均给予替罗非班0.15μg/kg持续静脉泵入36h。比较两组患者梗死动脉(IRA)开通率、IRA开通时间、肌酸激酶(CK)和肌酸激酶同工酶(CK-MB)峰值时间、并发症发生率及病死率。结果两组患者IRA开通率比较,差异无统计学意义(P>0.05);观察组IRA开通时间、CK和CK-MB峰值时间短于对照组,差异有统计学意义(P<0.05)。观察组无复流发生率低于对照组,差异有统计学意义(P<0.05);两组患者心绞痛、出血发生率及病死率比较,差异无统计学意义(P>0.05)。结论大剂量替罗非班在AMI介入治疗中的应用安全有效,且不增加并发症发生率。
Objective To investigate the efficacy and safety of high-dose tirofiban in the interventional therapy of acute myocardial infarction (AMI). Methods A total of 160 AMI patients undergoing percutaneous transluminal coronary angioplasty (PCI) from June 2008 to August 2012 in Wuxi Traditional Chinese Medicine Hospital were enrolled in this study. The patients were divided into observation group and control group according to the order of hospital admission, 80 cases each. Before the coronary angiography, the control group was given the conventional dose of tirofiban 10μg / kg, the observation group was treated with high dose tirofiban 20μg / kg, and then two groups of patients All patients were given tirofiban 0.15μg / kg intravenously for 36h. IRA opening rate, IRA opening time, peak time of creatine kinase (CK) and creatine kinase (CK-MB), complication rate and mortality were compared between the two groups. Results There was no significant difference in the rate of IRA opening between the two groups (P> 0.05). The IRA opening time and the peak time of CK and CK-MB in the observation group were shorter than those in the control group (P <0.05). The incidence of no-reflow in the observation group was lower than that in the control group, the difference was statistically significant (P <0.05). There was no significant difference in angina pectoris, bleeding incidence and mortality between the two groups (P> 0.05). Conclusion The high dose of tirofiban is safe and effective in the interventional treatment of AMI without increasing the incidence of complications.