替罗非班对高危非ST段抬高型急性冠脉综合征的疗效评价

目的 通过与常规治疗方案对比来评估替罗非班对高危非ST段抬高型急性冠状动脉（冠脉）综合征的疗效.方法 将自2012年2月至2013年10月在北京市大兴区人民医院就诊并诊断为高危非ST段抬高型急性冠脉综合征并符合纳入标准的患者226例随机分为替罗非班治疗的试验组和安慰剂治疗的对照组,其中试验组114例,对照组112例.分别在治疗后的第7、第14、第30和第90天（T1、T2、T3和T4）对观察指标进行测量并记录.研究的主要终点指标包括致命和非致命的心肌梗死,次要终点指标包括心脏原因以外的死亡和药物治疗无效的难治性心肌缺血.结果 与对照组相比,试验组主要终点事件的发生显著减少.试验组和对照组第7天时发生的主要终点事件分别是9和21例（P=0.039）;第14天分别是10和26例（P=0.021）;第30天分别是10和29例（P=0.019）;第90天分别是13和34例（P=0.012）.结论 研究结果证实替罗非班可以改善高危非ST段抬高型急性冠脉综合征患者的预后,疗效确切.

Evaluation on the role of tirofiban in high-risk non-ST-segment elevation acute coronary syndromes

Objectives To compare tirofiban combined with conventional therapy and conventional therapy for patients with high-risk non-ST-segment elevation （NSTE） acute coronary syndromes （ACS）,in order to evaluate the immediate and early outcomes.Methods Totally 226 patients who were diagnosed with high-risk NSTE ACS in The People＇s Hospital of Daxing District from February 2012 to October 2013 and met the inclusive criteria were randomly divided into two groups.In control group,112 patients received conventional therapy with a placebo,and in experimental group,114 patients received conventional therapy combined with tirofiban.Observation indexes were measured and recorded on the 7th,14th,30th and 90th day after therapy.The primary endpoint of our study was fatal and nonfatal myocardial infarction.Non-cardiac-caused death and refractory myocardial ischemia which was not amenable to conservative medical therapy was considered as secondary endpoints.Results A significant reduction was noted in the occurrence of primary endpoints in patients receiving tirofiban combined with conventional therapy,compared to those who received a placebo only.The numbers of primary endpoint events in experimental group and control group were 9 and 21 （P=0.039） on the 7th day,10 and 26 （P=0.021） on the 14th day,10 and 29 （P=0.019） on the 30th day and 13 and 34 （P=0.012） on the 90th day after therapy respectively.Conclusions Tirofiban can be effective in improving outcomes of patients with high-risk NSTE ACS.