替罗非班对平板运动试验ST段抬高患者临床疗效观察

观察盐酸替罗非班对平板运动试验中ST段抬高患者的临床疗效。将平板运动试验ST段抬高患者35例按就诊顺序双盲随机分为受试组(n=18)和对照组(n=17),受试组在对照组给予肝素治疗的基础治疗上加用盐酸替罗非班。结果:与对照组相比,受试组心绞痛的发作次数及持续时间明显降低(P<0.05),再发心绞痛、急性心肌梗死、心脏猝死的发生有下降趋势。结论:替罗非班可改善平板运动试验ST段抬高患者症状和可能的近期预后。     

替罗非班对非ST段抬高型急性冠状动脉综合征患者治疗疗效分析

目的探讨替罗非班对非ST段抬高型急性冠状动脉综合征患者治疗疗效。方法选择早期保守治疗的非ST段抬高型急性冠状动脉综合征患者134例,分为观察组67例与对照组67例。对照组采用常规治疗,观察组在对照组基础上应用替罗非班,48小时后比较治疗前后各组患者的血液流变学指标、氧自由基指标、炎症因子指标水平变化以及心绞痛治疗效果。结果替罗非班治疗组各测定指标优于对照组,明显改善心绞痛症状,且无明显不良反应。差异有统计学意义(P0.05)。结论替罗非班治疗非ST段抬高型急性冠状动脉综合征效果显著,并可改善患者血液流变学,促进氧自由基清除,减轻微炎症状态。     

替罗非班治疗不稳定型心绞痛/非ST段抬高心肌梗死的观察和护理

目的观察替罗非班治疗不稳定型心绞痛／非ST段抬高心肌梗死的临床效果，探讨应用替罗非班后主要不良反应（出血）的护理体会。方法本组符合不稳定型心绞痛／非ST段抬高心肌梗死患者44例。将其随机分为观察组（n=22）和对照组（n=22），观察组持续应用替罗非班72h，对照组除不给予替罗非班外，其他药物与观察组相同。观察用药期间两组患者心绞痛发作次数、心电图变化和主要不良反应（出血）情况。结果观察组患者心绞痛发作次数比对照组显著减少（P〈0．05），心绞痛发作最长一次时间较对照组缩短30．5％；观察组患者心电图ST段较对照组也有较多改善趋势；两组患者主要不良反应的发生率间差别无显著性意义（P〉0．05）。结论替罗非班治疗不稳定型心绞痛／非ST段抬高心肌梗死患者，可以进一步缓解心绞痛症状和改善心电图，治疗剂量无严重出血如颅内出血的发生。对不稳定型心绞痛／非ST段抬高心肌梗死是安全有效的。     

替罗非班治疗急性冠脉综合征的临床研究

目的 :本研究旨在评价替罗非班用于治疗中国人急性冠脉综合征的有效性和安全性。方法 :78例急性冠脉综合征患者按就诊顺序随机、双盲分配为受试组 (替罗非班 +肝素 )和对照组(安慰剂 +肝素 ) ,疗程 2～ 4 .5d。终点事件是 4 .5d和 30d的复合缺血事件 (死亡、新的心梗、顽固性心肌缺血 )。结果 :4 .5d复合终点事件发生率受试组低于对照组 (0 %vs 5 .2 6 % ,P =0 .117)。30d复合终点事件发生率受试组亦明显低于对照组 (0 %vs 2 1.0 5 % ,P =0 .0 83)。出血并发症在受试组比对照组有增多趋势 (2 0 .5 %vs 5 .13% ,P =2 .86 8)。结论 :替罗非班在急性冠脉综合征标准治疗基础上能进一步减少缺血事件发生率 ,且安全性良好     

强化抗血小板治疗对活动平板运动试验ST段抬高患者临床疗效观察

目的:观察强化抗血小板治疗对平板运动试验中ST段抬高患者的临床疗效。方法:平板运动试验ST段抬高患者65例按就诊顺序双盲随机分为受试组(n=33)和对照组(n=32),受试组在对照组给予阿司匹林、氯吡格雷、肝素等基础治疗上加用血小板膜糖蛋白Ⅱb/Ⅲa受体拮抗剂(盐酸替罗非班),观察2组临床疗效及不良反应发生情况。结果:受试组心绞痛的发作次数及发作平均持续时间,较对照组明显降低(P<0.05);疗程结束后行选择性冠状动脉造影术(SCA)检查,心肌梗死溶栓试验(TIMI)血流分级达3级比率高于对照组(P<0.05);主要终点事件有下降趋势;未出现严重不良反应。结论:强化抗血小板治疗,可改善平板运动试验ST段抬高患者的临床症状和近期预后,未发现严重出血等并发症。     

国产替罗非班治疗急性冠状动脉综合征的临床研究

目的在常规抗凝、抗血小板基础上,观察国产血小板膜糖蛋白Ⅱb/Ⅲa受体拮抗剂替罗非班治疗急性冠状动脉(冠脉)综合征的疗效和安全性。方法本试验为随机、双盲、安慰剂平行对照临床研究。符合急性冠脉综合征(不稳定型心绞痛/非Q波心肌梗死)入选标准患者62例,按就诊顺序双盲随机分为受试组(替罗非班,n=32)和对照组(n=30)。在均使用阿司匹林、氯吡格雷和肝素的基础上,试验组给予替罗非班(负荷量10μg/kg,在3min内推注),继以0.15μg/(kg.min)由微量泵持续泵入24~36h;对照组病例直接进行经皮冠状动脉介入治疗(PCI)。结果试验组30d内主要不良心脏事件(MACE,包括顽固性心绞痛/新发心肌梗死/死亡)发生率较对照组显著降低(9.3%比20.0%,P<0.05),心电图ST段下移程度和缺血导联数明显减少(P<0.05)。围术期出血并发症较对照组稍高,但差异无统计学意义。两组术后血小板计数、心功能(射血分数值)差异无统计学意义。结论国产替罗非班在急性冠脉综合征标准治疗基础上能进一步减少心肌缺血事件发生率,改善心电图心肌缺血改变,安全性好,但其长期疗效及毒副作用有待进一步观察。     

国产替罗非班治疗急性冠脉综合征行PCI术患者的临床效果

目的评价国产血小板膜糖蛋白（GP）IIb/IIIa受体拮抗剂替罗非班（tirofiban）治疗急性冠状动脉综合征（ACS）患者在接受肝素（包括低分子肝素）、盐酸氯吡格雷、阿司匹林基础上实施经皮冠状动脉介入治疗术的有效性和安全性评价。方法将32例ACS患者按就诊顺序随机双盲分为受试组（加用替罗非班）和对照组（加用安慰剂）,所有患者均正规使用肝素（包括低分子肝素）、盐酸氯吡格雷、阿司匹林。疗程48 h,观察指标为心电图改变、出血并发症、血小板聚集率,终点事件是5 d内的复合缺血事件。结果受试组心电图ST段改善情况好于对照组[（0.50±0.08）mVvs（0.42±0.07）mV,P<0.01];出血并发症比对照组有增多趋势,但无统计学差异（14%vs9%）;血小板聚集率受试组明显下降（38%±8%vs44%±8%,P<0.05）,受试组用药前后比较（45%±7%vs38%±8%,P<0.01）,对照组用药前后比较（45%±8%vs44%±8%）;5 d复合终点事件发生率受试组低于对照组（0%vs18%,但差异无显著意义）。结论替罗非班在ACS常规治疗基础上可以进一步改善心电图缺血性改变,并能进一步加强抗血小板作用,且安全性良好。     

替罗非班对非ST段抬高性急性冠脉综合征的疗效和安全性观察

目的 探讨盐酸替罗非班治疗非ST段抬高性急性冠脉综合征(ACS)的疗效和安全性.方法 选择46例非ST段抬高性ACS患者,观察替罗非班治疗前后心绞痛发作次数,心肌缺血改善程度及出血事件、血小板计数的变化.结果 替罗非班治疗后心绞痛发作次数减少,心肌缺血改善,治疗前后差异有统计学意义(P＜0.01),而血小板计数无明显改变(P＞0.05).结论 在非ST段抬高性ACS患者的治疗中不但能显著控制心绞痛发作,改善心肌供血,近而可改善其近、远期预后.     

冠脉内注射替罗非班对急性心肌梗死急诊介入治疗ST段回落的影响

目的:应用ST段回落指数观察冠脉内负荷替罗非班对急性心肌梗死直接经皮冠状动脉介入治疗的有效性和安全性。方法:选择因急性ST段抬高心肌梗死入院,并接受直接急诊经皮冠状动脉介入治疗患者92名,分为试验组(冠脉内负荷替罗非班+PCI)42例和对照组(静脉负荷替罗非班+PCI)50例。观察两组术后心电图ST段回落指数,PCI术前、术后TI-MI血流情况,术后30天射血分数(EF),30天主要心血管事件(心绞痛,再次心肌梗死和死亡)。结果:试验组术后2h、4h、8h心电图ST段回落指数均高于对照组(P<0.05),两组PCI术前梗死相关血管各级TIMI血流与对照组无显著性差异。试验组PCI术后即刻达TIMI 3级血流比例高于对照组(P<0.05),PCI术后30分钟达到TIMI 3级血流比例也显著高于对照组(P<0.05),试验组30天心脏射血分数高于对照组(P<0.05),试验组30天内主要心血管事件(心绞痛+再次心肌梗死+死亡)的发生率较对照组降低66.00%(P<0.05)。两组间所有出血相关并发症无显著性差异(P>0.05)。结论:ST段回落指数能有效评价急性心肌梗死急诊经皮冠状动脉介入治疗后心肌损伤程度,是最简单易行的评估方法;冠脉内负荷替罗非班在急性心肌梗死直接经皮冠状动脉介入治疗中改善术后心肌灌注,降低心血管事件,并不增加出血的风险。     

替罗非班治疗老年不稳定型心绞痛临床观察

目的 探讨血小板糖蛋白Ⅱb/Ⅲa受体拮抗剂替罗非班治疗老年不稳定型心绞痛的有效性和安全性.方法 将＞60岁＜80岁确诊为不稳定型心绞痛（高危组）的138例患者随机分为2组,对照组66例给予阿司匹林、氯吡格雷、低分子肝素、硝酸酯类及其他常规治疗,试验组72例在以上治疗基础上加用替罗非班,48 h持续静脉泵入.观察两组心绞痛症状缓解情况和心电图ST段变化,记录用药后48 h、1周、1个月心脏不良事件包括顽固性心绞痛、心肌梗死、心源性猝死及出血等不良反应发生.结果 与对照组相比,试验组心绞痛缓解有效率高,心电图压低ST明显改善（P＜0.05）,心脏不良事件发生率降低.两组均无严重不良反应,轻微出血反应试验组略高于对照组,但无统计学意义.结论 在阿司匹林、氯吡格雷、低分子肝素基础上加用替罗非班治疗老年不稳定型心绞痛安全、有效.     

Tirofiban therapy for patients with acute coronary syndromes and prior coronary artery bypass grafting in the PRISM-PLUS trial

The role of glycoprotein IIb/IIIa platelet receptor antagonist therapy for patients with an acute coronary syndrome (ACS) and a history of coronary artery bypass grafting (CABG) remains incompletely defined. We examined the outcomes of patients with an ACS and prior CABG who were treated with tirofiban versus placebo among subjects with prior CABG in the Platelet Receptor Inhibition in Ischemic Syndrome Management in Patients Limited by Unstable Signs and Symptoms (PRISM-PLUS) trial. Of 1,570 patients treated with tirofiban plus heparin (n = 773) or heparin alone (n = 797), 231 had prior CABG. Compared with patients without prior CABG, those with prior CABG were more likely to have risk factors for a complicated ACS course, including severe coronary artery disease and heart failure (all p <0.0001), typically had clinical predictors of benefit from tirofiban, such as ST-segment depression (p = 0.01) or a TIMI risk score >or=4 (p <0.001), and were more likely to die or have a myocardial infarction or refractory ischemia at all time points examined (p <0.0001). Among patients with prior CABG, decreases in the incidence of death, myocardial infarction, or refractory ischemia with tirofiban and heparin versus heparin alone were noted at 7 and 30 days (7 days: 16.9% vs 29.0%, p = 0.035; 30 days: 25.0% vs 40.2%, p = 0.015). Trends toward a decrease in death, myocardial infarction, and refractory ischemia with tirofiban and heparin versus heparin alone in the prior CABG subgroup were noted at 48 hours and 180 days (48 hours: 6.5% vs 14.0%, p = 0.09; 180 days: 37.1% vs 48.6%, p = 0.057). Bleeding rates were similar in patients with and without prior CABG. Tirofiban was well tolerated and tended to decrease the considerable risk for ischemic ACS complications in patients with prior CABG.     

Long-term clinical outcomes of platelet glycoprotein IIb/IIIa inhibitor combined with low molecular weight heparin in patients with acute coronary syndrome.

BACKGROUND: Platelet activation and aggregation with resultant arterial thrombus formation play a pivotal role in the pathophysiology of acute coronary syndrome (ACS). In the present study the efficacy of tirofiban, a specific inhibitor of the platelet glycoprotein IIb/IIIa receptor, combined with heparin or low-molecular-weight heparin (dalteparin), was evaluated for the management of ACS. METHODS AND RESULTS: One hundred and sixty patients (60.9+/-11.1 years, 104 male) with unstable angina or non-ST elevation myocardial infarction and who had ST-T changes and elevated troponin were randomly assigned to 4 groups: group I (n=40: heparin alone), group II (n=40: dalteparin alone), group III (n=40: tirofiban + heparin) and group IV (n=40: tirofiban + dalteparin). The occurrence of major adverse cardiac events (MACE) was compared prospectively during a 6-month clinical follow-up. Percutaneous coronary intervention or coronary artery bypass graft was performed in 32 cases in group I, 29 in group II, 28 in group III and 31 in group IV (p=0.72). Minor bleeding complication developed in 2 patients (5.0%) in group I, 2 (5.0%) in group II, 4 (10.0%) in group III and 3 (7.5%) in group IV (p=0.78). During the follow-up MACE occurred in 10 patients (31.3%) in group I, 9 (31.0%) in group II, 4 (14.3%) in group III and 4 (12.9%) in group IV (p=0.02: Group I and II vs Group III and IV). CONCLUSIONS: Tirofiban combined with dalteparin was associated with relatively more bleeding complications in the short term, but was effective in reducing the incidence of MACE during long-term clinical follow-up in patients with ACS.     

Combination therapy with tirofiban and enoxaparin in acute coronary syndromes

BACKGROUND: Tirofiban, an intravenous glycoprotein IIb/IIIa antagonist, and enoxaparin, a low molecular weight heparin, have each been shown to be effective at reducing cardiac ischemic events compared to unfractionated heparin alone in separate trials of patients with unstable angina and non-Q-wave myocardial infarction. The combination of these agents may offer further therapeutic benefit. MATERIALS AND METHODS: Fifty-five patients with non-Q-wave myocardial infarction were randomized to receive double-blind treatment with tirofiban (0.1 microgram/kg/min i.v.) for 48-108 h coadministered with either enoxaparin (1 mg/kg sc q 12 h) (n=26) or unfractionated heparin (i.v. adjusted to activated partial-thromboplastin time) (n=27) to evaluate pharmacokinetics, pharmacodynamics, and safety. The primary objective of the study was to investigate the effect of unfractionated heparin versus enoxaparin on the plasma clearance of tirofiban. RESULTS: Coadministration of tirofiban and enoxaparin was generally well tolerated. Plasma clearance of tirofiban was 176.7+/-59.8 and 187.5+/-81.8 ml/min, respectively, for enoxaparin and unfractionated heparin-treated patients (P=NS). The mean difference was well within the prespecified criterion for comparability. Administration of tirofiban with enoxaparin vs. unfractionated heparin resulted in lesser variability and a trend towards greater inhibition of platelet aggregation using 5 microM adenosine phosphate agonist. More patients achieved target inhibition of platelet aggregation >70% in the tirofiban and enoxaparin group (84% vs. 65%, P=0.19). Median bleeding time was 21 min for tirofiban and enoxaparin vs. > or =30 min for tirofiban and unfractionated heparin (P=NS). For a given level of inhibition of platelet aggregation, bleeding time was less prolonged with tirofiban and enoxaparin than tirofiban and unfractionated heparin (adjusted mean bleeding time 19.6 vs. 24.9 min, P=0.02). Tirofiban plasma concentration and clearance were comparable whether coadministered with enoxaparin or unfractionated heparin. There were no major or minor bleeding events in either group by the TIMI criteria. INTERPRETATION: The more consistent inhibition of platelet aggregation and lower adjusted bleeding time of tirofiban and enoxaparin vs. tirofiban and unfractionated heparin support the therapeutic potential of combining these two agents. These data from the first clinical report of coadministration of a glycoprotein IIb/IIIa receptor antagonist and a low molecular weight heparin are consistent with prior data which show differential pharmacodynamic effects of enoxaparin and unfractionated heparin on platelet aggregation.     

使用替罗非班时泮托拉唑对非ST段抬高型急性冠脉综合征患者消化道保护作用的评

目的:盐酸替罗非班、阿司匹林、氯吡格雷、低分子肝素（四联）联合使用治疗急性冠脉综合征(ACS)患者时,评价静脉注射泮托拉唑对消化道保护的疗效和安全性。方法: 选择住院ACS患者296例,随机分为试药组184例,对照组112例,所有患者均服用阿司匹林、氯吡格雷、低分子肝素和使用2～3 d盐酸替罗非班。在此基础上试药组患者静脉输注泮托拉唑40 mg/d,4~5 d,再服用泮托拉唑片剂40 mg/次,2次/d,连服8 d。结果: 试药组8 d内全因死亡、顽固性心绞痛、再次心肌梗死、急诊经皮冠状动脉介入治疗(PCI)数较对照组显著减少（P<0.05）;试药组与对照组比较消化道出血发生率（2.2% vs. 12.5%）、TIMI小出血发生率(1.6% vs. 6.2%)和TIMI较小出血发生率(0.5% vs. 5.4%)明显降低（P<0.05）。结论: 在四联抗栓治疗ACS患者时,静脉注射和口服泮托拉唑可以减少8 d内消化道出血发生率,从而减少了8 d内患者死亡、顽固性心绞痛、再次心肌梗死、急诊PCI数,具有良好的消化道保护作用和安全性。     

Effects of tirofiban plus heparin versus heparin alone on troponin I levels in patients with acute coronary syndromes

Elevated serum troponins following an acute coronary syndrome (ACS) predict a poor clinical outcome. Glycoprotein (GP) IIb/IIIa inhibitors reduce adverse clinical outcomes in patients with ACS, although their effect on serum troponin I (TnI) in this setting has not been described. We therefore studied the effects of the GP IIb/IIIa inhibitor tirofiban on serum TnI levels in a group of patients in the Platelet Inhibition in Ischemic Syndrome Management in Patients Limited by Unstable Signs and Symptoms trial. Serial blood samples were obtained in 53 patients receiving the combination therapy of tirofiban/heparin and in 52 receiving heparin alone, and were analyzed for baseline, peak, and mean concentrations of TnI. Baseline TnI levels were not different between the combination therapy and heparin-only groups (1.6 +/- 3.0 vs 3.1 +/- 6.7 ng/ml, p = 0.15). The peak TnI level was significantly lower in the combination therapy group than in the heparin group (5.2 +/- 8.3 vs 15.5 +/- 29.1 ng/ml, p = 0.017), and mean levels over the initial 24-hour period were also significantly lower in the combination therapy group (3.2 +/- 5.0 vs 8.5 +/- 14.8 ng/ml, p = 0.016). In univariate analysis, combination therapy was associated with lower TnI levels, whereas in a multivariate model, the lower peak and mean TnI levels as a consequence of tirofiban/heparin compared with heparin monotherapy remained significant (peak, p = 0.029; mean, p = 0.035). Among patients with negative TnI at baseline, treatment with the combination of tirofiban/heparin compared with heparin monotherapy still resulted in significantly lower peak (2.5 +/- 5.4 vs 14.6 +/- 32.8 ng/ml, p = 0.024) and mean (1.2 +/- 2.6 vs 6.9 +/- 15.8 ng/ml, p = 0.029) TnI levels. In patients with ACS, therapy with the combination of tirofiban and heparin (compared with heparin treatment alone) resulted in lower serum TnI levels, suggesting reduced myocardial injury.     

替罗非班对急性冠脉综合征患者血小板活化度的影响

目的:评价GPⅡb/Ⅲa受体拮抗剂(盐酸替罗非班)对急性冠脉综合征(ACS)患者血小板活化度的影响及临床安全性。方法:受试组患者为来自2005年1月～2008年1月我院就诊的急性非ST段抬高型心肌梗塞和不稳定型心绞痛ACS患者,共126例,接受盐酸替罗非班持续泵入24～48h,根据年龄、性别选取同期就诊的稳定型心绞痛冠心病患者112例作为对照组。应用流式细胞仪分别对受试组和对照组患者CD61、CD62p、活化的GPⅡb/Ⅲa(PAC-1)的表达情况进行分析。结果:受试组CD61、PAC-1指标应用替罗非班1.5～2h,10h,48h比用药前明显降低(P均0.01),而对照组在治疗前后无明显变化;CD61仅用药1.5h时两组间比较有显著差异(P0.001);受试组PAC-1水平在治疗1.5～2h,10h时明显下降(P0.05),在48h又出现明显升高(P0.05)。结论:急性冠脉综合征患者应用GPⅡb/Ⅲa受体拮抗剂可改善长期的临床预后,同时我们的研究也显示替罗非班治疗急性冠脉综合症是有效的和安全的。     

Analysis of bleeding complications associated with glycoprotein IIb/IIIa receptors blockade in patients with high-risk acute coronary syndromes: insights from the PRISM-PLUS study

We aim to characterize the hemorrhagic complications and predictors of increased bleeding risk in a population of patients with high-risk acute coronary syndromes (ACS), enrolled in the PRISM-PLUS study. Patients treated with heparin plus tirofiban had more bleeding events compared to patients treated with heparin alone. No significant increase in major bleeding, thrombocytopenia, blood loss and blood products transfusions was observed among the patients who received the combination therapy. Several clinical variables were independently associated with increased risk of bleeding for both treatment groups: advanced age, lower body weight, female gender, decreased creatinine clearance (<30 ml/min). Females, patients with impaired renal function, patients requiring percutaneous coronary intervention (PCI), especially prolonged PCI (>100 min duration) or coronary artery bypass surgery (CABG) were at risk for increased major bleeding complications. Increased blood loss was also found in females, patients with elevated diastolic blood pressure, PCI, duration of PCI>100 min or CABG. No incremental risk was detected with the addition of tirofiban to heparin in patients at risk for major bleeding or increased blood loss. We concluded that identification of patients with high-risk ACS, at risk for bleeding complications and blood loss can be done with specific clinical variables. Tirofiban added to heparin increased minor hemorrhagic complications. Although there was no significant increase in major bleeding, thrombocytopenia and blood transfusions with the combination of tirofiban plus heparin, the power to detect a statistically significant difference in these endpoints was limited by the small number of events.     

急性冠状动脉综合征早期盐酸替罗非班治疗对血清可溶性CD40配体水平的影响

目的观察急性冠状动脉综合征(ACS)早期盐酸替罗非班治疗对血清可溶性CD40配体(sCD40L)水平的影响,了解盐酸替罗非班对ACS斑块稳定性和免疫炎症抑制的作用。方法143例初次确诊为ACS患者分为常规治疗组76例和盐酸替罗非班治疗组67例,用ELISA法测定143例ACS患者治疗前后血清sCD40L水平。结果盐酸替罗非班治疗组67例ACS患者治疗后血清sCD40L水平明显下降,与常规治疗组比较有显著统计学差异(P<0.01)。结论ACS患者早期予以盐酸替罗非班治疗,可明显降低血清炎症因子水平,从而改善该病进程。     

替罗非班对急性冠脉综合征伴糖尿病患者介入术后心肌灌注及心肌损伤的影响

目的探讨替罗非班对急性冠脉综合征（ACS）伴糖尿病（DM）患者冠状动脉介入（PCI）术后心肌灌注及及心肌损伤的影响。方法选择ACs合并DM患者92例,随机分为两组,对照组（n=45）应用阿司匹林、氯吡格雷、低分子肝素钙抗凝等常规治疗;替罗非班组（n=47）在常规治疗基础上加用替罗非班。观察两组患者冠脉内注药20min后梗死相关动脉（IRA）的TIMI及心肌灌注血流分级,术后8h、12h、24h的心肌肌钙蛋白T（cTnT）、超敏C反应蛋白（hs—CRP）,主要不良心血管事件及出血发生率。结果术后8h、12h、24h替罗非班组的cTnT、hs—CRP均显著低于对照组（P〈O．05或P〈0．01）。冠脉内注药后20min行冠脉造影,替罗非班组IRA的TIMI及心肌灌注血流分级均显著优于对照组（P〈0．05）。替罗非班组心血管事件发生率显著低于对照组（P〈0．05）;术后30d内两组出血并发症的发生率差异无统计学意义（P〉0．05）。结论在常规抗凝基础上合用盐酸替罗非班治疗ACS合并糖尿病患者,可明显改善心肌灌注,减少心肌损伤．减少心血管事件。