不同剂量替罗非班联合冠脉介入治疗对非ST段抬高型急性冠脉综合征的疗效及安全性

目的:探讨不同剂量替罗非班联合冠脉介入治疗对非ST段抬高型急性冠脉综合征(Non ST-segment elevation acute coronary syndromes,NST-ACS)的疗效及安全性。方法:选择我院2014年10月至2016年6月收治的110例NST-ACS患者,根据随机数字表法,分为全剂量组及半剂量组。观察两组患者治疗前后的TIMI血流分级情况、术前及术后30 d的心功能、主要心血管事件及出血事件、住院费用及住院天数。结果:与术前相比,两组的TIMI 2级和3级血流分级显著降低;术后30 d两组患者的左室收缩末期容积(left ventricular end diastolic volume,LVEDV)、左室舒张末期容积(left ventricular end systolic volume,LVESV)均明显下降,而左室射血分数(left ventricular ejection fraction,LVEF)均明显上升,P均0.05;而术前、术后组间TIMI血流分级、LVEDV、LVESV及LVEF对比无统计学意义,两组的主要心血管事件及住院时间对比差异无统计学意义,P均0.05;而全剂量组组的出血事件及住院费用对比明显高于半剂量组,P0.05。结论:半剂量组的替罗非班联合冠脉介入治疗对NST-ACS疗效显著,且可降低患者的出血事件及住院费用,值得临床推广应用。

Efficacy and Safety of Different Doses of Tirofiban Combined with Coronary Artery Intervention in Treatment of Non ST-segment Elevation Acute Coronary Syndromes

ABSTRACT Objective: To investigate the efficacy and safety of different doses of tirofiban combined with coronary artery intervention in treatment of Non ST-segment elevation acute coronary syndromes (NST-ASC). Methods: 110 cases with NST-ACS from October 2014 to January 2016 in our hospital were chosen and divided into the all dose group and half dose group. The TIMI blood grade before and after treatment, cardiac function before and after treatment for 30 d, major adverse cardiac events and bleeding events, hospitalization expenses and hospitalization days were recorded and compared between two groups. Results: Compared with before treatment, the TIMI 2 grade and 3 grade were obvious decreased, and the left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV) after treatment for 30 d were all obvious decreased, while the left ventricular ejection fraction (LVEF) were significant increased, P<0.05. And the TIMI blood flow grading, LVEDV, LVESV and LVEF before and after treatment in two groups had no significant difference (P>0.05), and the major adverse cardiac events and hospitalization days of two groups had no significant difference, P>0.05. While the bleeding events and hospitalization expense of all dose group was obvious higher than those of half dose group, P<0.05. Conclusion: The half dose group of tirofiban combined with coronary artery intervention in treatment NST-ACS has obvious efficacy, it can decrease the bleeding events and hospitalization expense.