替罗非班致出血27例临床分析

目的:总结替罗非班致出血的临床表现及致出血因素。方法:回顾性分析2011年1月-2013年8月接受替罗非班治疗并发出血的冠心病患者27例的临床资料。结果:本组≥65岁患者占81.5%(22/27);18例有相关的基础疾病,3例发生在PCI术后,6例无明显诱因;肉眼血尿8例,牙龈出血5例,咯血4例,鼻衄3和皮下瘀斑各3例,心包填塞、右前臂出血血肿、右股动脉血肿及消化道出血各1例;21例患者停药后出血可自愈,6例经对症处理止血。结论:替罗非班治疗冠心病致出血并发症的临床表现多样;致出血相关因素有介入操作技术及器械选择、合并相关基础疾病、老龄:用药时需密切观察出血情况并及时处理。

Clinical Analysis of 27 Patients with Hemorrhage Caused by Tirofiban

Objective：To summarize the clinical manifestations and risk factors of hemorrhage induced by Tirofiban. Methods： The clinical data of 27 patients with coronary heart disease complicated with hemorrhage treated by Tirofiban were analyzed retrospectively from Jan 2011 to Aug 2013. Results： Among the 27 cases, age ≥65 years accounted for 81.5%（22/27）. 18 cases were related underlying disease, 3 cases occurred after PCI and 6 cases were not obvious incentive. 8 cases occurred gross hematuria, 5 cases bleeding gums, 4 cases hemoptysis, 4 cases ecchymosis, 3 cases epistaxis, 1 case pericardial tamponade, right forearm hematoma, right femoral artery hematoma and gastrointestinal hemorrhage respectively. 21 cases healed by stop taking Tirofiban and 6 cases needed symptomatic treatment. Conclusion： The clinical manifestations of Tirofiban treatment-induced hemorrhage complications varied. Risk factors of hemorrhage complications include intervention operation techniques and equipment selection, combined underlying diseases and the aging. Medication of Tirofiban should be observed carefully and treat the hemorrhage complications timely.