替罗非班在急性冠状动脉综合征介入治疗中的安全性及有效性

目的观察国产血小板膜糖蛋白Ⅱb/Ⅲa受体拮抗剂替罗非班(欣维宁)在介入治疗急性冠状动脉综合征(ACS)中的安全性和有效性。方法195例ACS患者随机分为受试组(替罗非班+PCI治疗组,100例)和对照组(PCI治疗组,95例),疗程24 h。结果替罗非班组90 d内的主要不良心脏事件(MACE)发生率低于对照组。替罗非班组和对照组均未见大出血,皮肤、黏膜出血发生率分别为12%和6.3%,两组之间出血并发症发生率无显著性差异(P>0.05)。结论替罗非班在ACS的标准治疗基础上能进一步减少心肌缺血事件,且安全性好。     

替罗非班在急性冠状动脉综合征介入治疗中的疗效与安全评价

目的探讨国产替罗非班在急性冠状动脉综合征(ACS)介入治疗(PCI)中的临床效果与安全性。方法选取急性冠状动脉综合征患者80例,随机分为对照组与观察组,各40例。对照组采用PCI治疗,观察组采用PCI与替罗非班治疗。结果对比90 d内主要不良心脏事件,组间无差异(P>0.05),但观察组有下降趋势;两组均无大出血,皮肤、黏膜出血发生率无组间差异(P>0.05)。结论国产替罗非班可用于ACS介入治疗,安全可靠,能进一步减少心肌缺血事件,值得推广应用。     

高龄急性冠状动脉综合征患者PCI术后应用半剂量替罗非班的临床观察

目的观察半剂量替罗非班在高龄(年龄≥75岁)急性冠状动脉综合征(ACS)患者经皮冠状动脉介入治疗(PCI)后应用的近期疗效和安全性。方法 70例择期行PCI的高龄ACS患者被随机分为常规治疗组(35例)和替罗非班组(35例)。常规治疗组应用抗凝、抗血小板治疗,替罗非班组另加用半剂量替罗非班。观察两组的不良反应(出血、血小板减少)发生率以及住院期间及术后30d内的主要心血管事件(死亡、顽固性心绞痛、新的心肌梗死)。结果与常规治疗组相比,替罗非班组出血事件发生率有轻度增加,但无显著性差异(22.9%VS 17.1%,P>0.05);住院期间及术后30天的主要心血管事件发生率替罗非班组低于常规治疗组,差异有统计学意义(2.9%VS 17.1%,P<0.05)。结论对于75岁以上高龄急性冠状动脉综合征患者,PCI术后应用半剂量替罗非班可减少主要心血管事件,且不明显增加出血合并症,相对安全、有效,值得临床推荐。     

PCI术前应用替罗非班对ACS患者疗效和安全性研究

目的分析替罗非班(Tirofiban)对急性冠状动脉综合征(ACS)患者治疗的效果和安全性以及冠状动脉介入手术(PCI)前使用的最佳时机。方法 239例高危并接受PCI治疗的ACS患者,随机分为PCI术前使用组91例、术后立即使用组95例和未使用组53例。术前使用组应至少在PCI术前4 h使用罗非班;而术后立即使用组在PCI术后立刻使用;未使用组在术前术后都不使用替罗非班。对三组血小板聚集率、PCI手术前后肌酸激酶同工酶(CK-MB)和TIMI血流情况和7、30、90 d主要心脏不良问题发生几率、急性血栓事件和出血事件与血小板减少症状的发生几率进行观察。结果在PCI手术前和手术后使用罗非班,能够在手术后的24 h内有效的抑制肌酸激酶同工酶水平的增加,与未使用组相比,差异具有统计学意义(P<0.05)。替罗非班在术前、术后以及未使用相比较,术前使用能够提高靶血管的TIMI 3级血流的获得率,三组术后差异无统计学意义(P>0.05),但术前使用组的发生率较低。三组均没有发生重度和中度出血,轻度出血、血小板减少症的发生几率差异无统计学意义(P>0.05)。结论在PCI术前使用替罗非班能够降低急性冠状动脉综合征患者血小板的聚集水平,还能够提高手术前TIMI血流,降低术后心肌损伤和急性血栓事件发生的几率,同时减少术后主要不良心脏事件(MACE)的发生。     

国产替罗非班在复杂冠状动脉病变介入治疗中的临床使用研究

目的研究国产替罗非班在复杂冠状动脉病变介入治疗中的临床应用疗效。方法选取复杂冠状动脉病变择期PCI患者120例为研究对象,在进行常规抗血栓治疗的基础上静脉使用血小板GPⅡb/Ⅲa受体拮抗剂替罗非班60例为试验组,常规抗血栓治疗患者60例为对照组,对比分析两组患者术后心绞痛、30 d的主要不良心血管事件(MACE)及轻微、严重出血发生率。结果试验组无MACE发生,对照组发生2例于30 d内不明原因猝死,2例急性支架血栓形成致急性心肌梗死,支架内血栓形成对比两组无明显统计学意义(P>0.05)。两组均有心绞痛发生,试验组明显低于对照组(16.7%vs.3.3%),有统计学意义(P<0.05)。两组患者均无严重出血,轻微出血发生率方面两组无显著差异(P>0.05)。结论对于复杂冠状动脉病变行介入治疗,在进行常规抗血栓的基础上联合应用静脉替罗非班疗效和安全性较好。     

替罗非班治疗冠状动脉介入中无复流的疗效观察

目的评价冠状动脉内注射国产盐酸替罗非班对急性冠状动脉综合征(acute coronary syn-drome,ACS)介入术后无复流患者冠状动脉TIMI血流的影响安全性及可行性。方法将ACS患者经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后判定无复流者67例,分为A组(冠状动脉内注射维拉帕米200μg及盐酸替罗非班10μg/kg)32例和B组(冠状动脉内注射维拉帕米200μg)35例。观察给药后10min TIMI血流分级及校正的TIMI计帧数(CTFC),出血并发症及30d内主要不良心血管事件(MACE)发生率。结果 A组介入术后无复流患者TIMIⅢ级血流获得率(65.6%)高于B组(42.9%)(P<0.05);CTFC显示替罗非班组血流快于维拉帕米组(P<0.01);出血并发症发生率和30d内MACE发生率与维拉帕米组差异均无统计学意义(P>0.05)。结论冠状动脉内注射国产盐酸替罗非班治疗ACS介入术后无复流患者是有效和安全可行的。     

冠脉内使用替罗非班治疗ST段抬高型心肌梗死的临床观察

目的评价急诊行经皮冠状动脉介入治疗(PCI)的急性ST段抬高型心肌梗死(STEMI)患者冠脉内使用替罗非班的疗效及安全性。方法62例拟行急诊PCI术的STEMI患者随机进入对照组(未用替罗非班,20例)、替罗非班IV组(静脉内推注替罗非班,21例)和替罗非班IVIC组(静脉和冠脉内推注替罗非班,21例),观察患者PCI术后心肌梗死溶栓治疗(TIMI)血流分级、校正的TIMI帧数(CTFC)、肌酸激酶同工酶(CK-MB)水平、超声心动图主要不良心血管事件(MACE)和出血事件。结果与对照组相比,替罗非班IV组及替罗非班IVIC组患者术后CTFC、CK-MB水平和左室射血分数(LVEF)均有改善,且替罗非班IVIC组各项指标差异均有统计学意义;但TIMI血流分级、出血事件的发生率、住院期间MACE和住院天数等组间差异均无统计学意义。结论在STEMI患者急诊PCI术中,单纯静脉或静脉和冠脉内推注替罗非班疗效优于未接受替罗非班者,且静脉和冠脉内推注的近期疗效优于单纯静脉推注。     

替罗非班联合急诊冠脉介入术治疗急性ST抬高性心肌梗死的临床观察

目的探讨早期应用替罗非班联合急诊经皮冠脉介入治疗术(PCI)治疗急性心肌梗死(AMI)患者的疗效和临床预后。方法所有确诊ST段抬高性心肌梗死(STEMI)并于发作6h内行急诊PCI手术患者120例,随机分为A组和B组,各60例,两组均给予急诊PCI术、氯吡格雷、阿司匹林,A组另给予替罗非班静脉内使用,观察两组术后即刻靶血管TIMI血流分级、术后心电图改变(ST段回落幅度)、术后30d内心脏不良事件(MACE)及出血事件发生率情况。结果 A组PCI术后即刻靶血管TIMI血流分级明显高于B组,使用替罗非班治疗期间,A、B组出血事件及血小板减少症发生率比较,差异无统计学意义(P>0.05),A组术后ST段回落幅度较B组明显、30d内MACE发生率明显低于B组。结论在阿司匹林、氯吡格雷抗血小板治疗的基础上,ACS患者急诊PCI术中应用替罗非班比单纯PCI术及常规药物治疗,能进一步改善心肌灌注,从而改善预后。     

替罗非班在高龄急性冠脉综合征患者介入治疗中的应用剂量探讨

替罗非班是血小板糖蛋白(GP)Ⅱb、Ⅲa受体拮抗剂,现已广泛应用于急性冠脉综合征(ACS)的治疗,并且能改善经皮冠状动脉介入治疗(PCI)后心肌组织供血,降低主要不良心血管事件发生[1]。尽管替罗非班抗血小板疗效好、安全性高,但在高龄患者中,常规剂量替罗非班仍显著增加了主要出血事件发生[2],因此,在高龄患者中,其应用剂量尚有待进一步探讨。本研究旨在探讨75岁以上ACS患者接受PCI治疗时应用替罗非班的剂量和安全性。     

替罗非班在急性心肌梗死介入治疗中的疗效

目的:研究ST段抬高型急性心肌梗死(AMI)患者在急诊行经皮冠状动脉介入术(PCI)中应用替罗非班的有效性和安全性. 方法:患者80名,随机分为试验组(替罗非班+PCI组)40例,对照组(PCI组)40例.观察PCI术前、术后梗死相关动脉(IRA)TIMI血流情况以及患者7d内两组患者心血管事件(MACE)的发生率,及术后两组惠者的出血发生率. 结果:介入术后造影显示替罗非班组患者恢复TIMI 3级血流比例明显高于对照组.住院期间替罗非班组心血管事件发生率较对照组低(P<0.05).而两组间术后出血比例差异无统计学意义. 结论:ST段抬高型急性心肌梗死(AMI)患者在急诊冠状动脉介入术中使用血小板膜糖蛋白Ⅱb/Ⅲa受体拮抗剂替罗非班是有效并且安全的,其疗效优于常规治疗组.     

冠心病介入治疗中应用欣维宁的疗效研究

目的 探讨冠心病患者经皮冠状动脉(冠脉)介入治疗(PCI)中应用欣维宁的安全性和有效性.方法 人选248例申请一次性PCI患者.所有患者均签署了知情同意书.248例患者最终完成PCI治疗者131例,未接受PCI治疗117例.研究采用随即对照方法,将患者分为欣维宁组(135例)和普通治疗组(113例).欣慰宁组于术中开始静脉注射欣维宁,观察患者术后情况和2个月内的临床终点事件.结果 131例患者,手术全部成功.欣慰宁组与普通治疗组心电图在治疗后有明显差异.普通治疗组53例患者中有1例在术后发生亚急性支架血栓,欣维宁治疗后血栓阴影消失,血流恢复正常.结论 对于进行PCI的冠心病患者,术中及术后静脉给予欣维宁是安全和有效的.     

依替巴肽与替罗非班在急性非ST段抬高型心肌梗死患者介入治疗中的药物经济学研究

目的:本研究旨在对比依替巴肽与替罗非班在急性非ST段抬高型心肌梗死(NSTEMI)患者介入治疗中的成本-效果分析,为中国NSTEMI患者经皮冠状动脉介入治疗(PCI)抗栓药物的选用提供依据及参考.方法:基于Markov数学模型,以国内医疗成本为成本数据,以国内外临床研究结果为疗效指标,利用Treeage软件模拟计算使用...     

Analysis of number needed to treat and cost of platelet glycoprotein IIb/IIIa inhibitors in percutaneous coronary interventions and acute coronary syndromes

This retrospective review and analysis of pivotal clinical trials compared acquisition costs and outcomes of platelet glycoprotein IIb/IIIa inhibitors. Absolute reduction in the number of deaths and nonfatal myocardial infarctions at 30 days, number of patients that need to be treated to prevent one event, and drug costs expended to prevent one event were assessed. In patients undergoing percutaneous coronary intervention (PCI), abciximab is the better value, especially in high-risk patients. In those with unstable angina and non-Q wave myocardial infarction, costs of eptifibatide and tirofiban were not significantly different, but the cost of tirofiban was more variable. These agents have the potential to be cost-effective if administered to populations at high risk for adverse outcomes of acute coronary syndromes or PCI. Prospective methods to identify these high-risk patients are being developed.     

早期使用替罗非班对非ST段抬高冠脉综合征心肌灌注和肌钙蛋白释放水平的影响

目的比较在高危非ST段抬高性急性冠脉综合征患者中,早期和导管室内使用替罗非班介入治疗前后心肌组织水平灌注和肌钙蛋白水平。方法138例急性非ST段抬高性急性冠脉综合征拟行冠脉介入治疗的患者,随机分为两组,分别于早期（病房内）和导管室内（造影后）静脉给予替罗非班,比较两组手术前后心肌梗死溶栓治疗临床试验心外膜血流分级（TIMI）和心肌灌注分级（TMPG）并检测肌钙蛋白Ⅰ的水平以观察心肌损伤。结果两组患者中,介入治疗前后TIMI3级血流无显著差异（P〉0．05）,心肌灌注（TMPG）3级水平介入治疗前后于早期使用替罗非班组明显优于导管室内使用组（P〈0．05）,术后肌钙蛋白Ⅰ水平在早期使用组明显低于导管室内使用组（P〈0．05）。结论在高危非ST段抬高性急性冠脉综合征患者中,早期使用替罗非班可以改善介入治疗前后心肌灌注和减少心肌损伤。     

Eptifibatide: a review of its use in patients with acute coronary syndromes and/or undergoing percutaneous coronary intervention

Eptifibatide (Integrilin) is a highly specific, reversible, intravenously administered glycoprotein (GP) IIb/IIIa receptor antagonist that acts at the final common step of the platelet aggregation pathway. Data from large clinical trials indicate that intravenous eptifibatide as adjunctive therapy to standard care is effective in patients with non-ST-segment elevation (NSTE) acute coronary syndromes (ACS) and/or undergoing percutaneous coronary intervention (PCI). In the ESPRIT (Enhanced Suppression of the Platelet glycoprotein IIb/IIIa Receptor with Integrilin Therapy) trial in patients undergoing PCI with stenting, eptifibatide, compared with placebo, achieved significant reductions in death and ischaemic complications and was better than a strategy of reserving treatment for the bailout situation. In the large PURSUIT (Platelet IIb/IIIa in Unstable angina: Receptor Suppression Using Integrilin Therapy) trial in patients with NSTE ACS, eptifibatide was associated with a significant reduction in the incidence of death or myocardial infarction (MI) compared with placebo. Eptifibatide is well tolerated in these trials. Ongoing trials are currently investigating the efficacy and tolerability of regimens that include this agent in other indications, including ST-segment elevation MI (STEMI).     

Eptifibatide: a pharmacoeconomic review of its use in percutaneous coronary intervention and acute coronary syndromes

Eptifibatide (Integrilin) is a selective inhibitor of platelet glycoprotein (GP) IIb/IIIa receptors used as adjunctive therapy for patients undergoing percutaneous coronary intervention (PCI) and for patients with acute coronary syndromes (ACS), particularly those requiring PCI. Most economic analyses of eptifibatide have incorporated clinical and healthcare resource use data from either the ESPRIT (Enhanced Suppression of the Platelet IIb/IIIa Receptor with Integrilin Therapy) study in low- to moderate-risk patients undergoing selective PCI with stent implantation or the PURSUIT (Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy) trial in patients with ACS. Eptifibatide achieved statistically significant reductions in combined endpoints of death and ischaemic complications in both of these large multicentre clinical trials, in which patients were randomised to receive intravenous eptifibatide or placebo as adjunctive therapy to heparin and aspirin (plus a thienopyridine in ESPRIT). In US economic analyses using ESPRIT trial data, approximately 40% and 70% of the acquisition cost of eptifibatide was offset by reduced medical resource consumption during the initial hospitalisation period and over a 1-year period, respectively. Eptifibatide was associated with a favourable cost-effectiveness ratio of $US1407 (year 2000 costs) per life-year gained (LYG) in a retrospective US cost-effectiveness analysis that incorporated data from the ESPRIT trial and modelled life expectancy using a large cardiovascular database.Several cost-effectiveness analyses used prospectively collected data from the PURSUIT trial and modelled survival projections using similar methods. These analyses, conducted in the US, Canada and Western Europe, also showed favourable results ($US3761-$US18 774 per LYG; various years of costing). Cost-utility ratios reported in US analyses varied somewhat, but remained <$US20 000 per quality-adjusted life-year gained (1996 values) when clinical efficacy data were derived from the US cohort of PURSUIT. CONCLUSION: Significant clinical benefits have been demonstrated with eptifibatide as adjunctive therapy in patients undergoing selective PCI with stent implantation in the ESPRIT trial and in patients with ACS in the PURSUIT trial. Pharmacoeconomic analyses using data from either ESPRIT or PURSUIT have demonstrated favourable cost-effectiveness ratios for both indications in various countries. ESPRIT-based results from the limited number of available economic analyses are particularly favourable. The cost-effectiveness of eptifibatide in ACS (i.e. PURSUIT-based results) may be further improved by targeting the drug for patients in whom catheterisation and PCI are planned, although further analyses are required to confirm this.     

盐酸替罗非班对急性ST段抬高型心肌梗死患者急诊PCI治疗后左心室功能及预后的影响

目的 探讨急性ST段抬高型心肌梗死(STEMI)患者急诊经皮冠状动脉介入(PCI)治疗时联合应用盐酸替罗非班对心肌灌注、左心室功能、血清高敏C反应蛋白(hs-CRP)水平及预后的影响.方法 连续入选2009年1月至2010年3月确诊为急性STEMI并接受急诊PCI治疗患者96例,完全随机分为试验组和对照组.比较2组患者术后即刻造影结果、术后7 d及60 d左心室功能、90 d主要不良心脏事件(MACE)发生率及治疗前后hs-CRP水平.结果 试验组术后2 h ST段回落＞50%者19例(38.0%)、CK-MB达峰值时间(13±3)h,均优于对照组的12例(26.1%)、(15±2)h,差异均有统计学意义(均P＜0.05).试验组无复流发生率4.0%,明显低于对照组的无复流发生率6.5%(P＜0.05).试验组术后7 d的LVEF、LVEDV均优于对照组,术后60 d的LVEF、LVEDV、LVESV亦均优于对照组,差异均有统计学意义(均P＜0.05).随访60 d内对照组MACE发生率为6.5%,明显高于试验组2.0%,差异有统计学意义(P＜0.05).对照组和试验组用药5 d后hs-CRP水平[(6.4±2.9)mg/L、(4.6±2.6)mg/L]均明显低于用药前[(9.6±2.8)mg/L、(9.8±2.3)mg/L],差异均有统计学意义(均P＜0.05);2组治疗后hs-CRP水平差异亦有统计学意义(P＜0.05).结论 对于急性STEMI患者行急诊PCI联合静脉应用盐酸替罗非班治疗可减少无复流现象的发生,改善心肌水平再灌注状态,改善左心室功能,提高临床预后.盐酸替罗非班能够通过抑制炎性反应从而延缓急性心肌梗死的进程.

Abstract：

Objective To study the effects of primary percutaneous coronary intervention combined with tirofiban therapy on myocardial perfusion and clinical outcomes in patients with acute ST-segment myocardial infarction(STEMI) and to observe the effect of tirofiban hydrochlotide on serum hs2CRP level. Methods Ninty-six consecutive patients with acute STEMI were randomly allocated to either primary PCI combined with tirofiban therapy or primary PCI treatment alone. Baseline characteristics, left ventricular ejection faction, majoradverse cardiac events (MACE) were cospared. Serum hs-CRP leves were determinded by the latex enhanced immunoturbidimetric method. Results The baseline clinical characteristics were comparable between the two groups. The TIMI grade 3 flow was similar between the tirofiban and control groups, but the resolution of sum of ST-segment elevation, peak-value of CK-MB, EF, LVEDD, LVESD, and the MACE rates at 60 days in tirofiban group were better than those in the control group. The level of hs-CRP had no significant difference between two groups before treatment, but after treatment, serum hs-CRP was significantly decreased by tirofiban hydrochloride treatment compared to the control group.Conclusions Adjunctive therapy with tirofiban for patients with acute STEMI who undergo primary PCI can improve reperfusion in the infarction area and clinical outcomes at 60 days. Tirofiban hydrochloride can delay the process of ACS via inhibiting inflammation.     

Current strategies with eptifibatide and other antiplatelet agents in percutaneous coronary intervention and acute coronary syndromes

Antiplatelet and anticoagulation therapies are essential for the prevention of thromboembolic-induced myocardial ischaemia in non-ST-elevation acute coronary syndromes and the ischaemic complications of percutaneous coronary intervention. Although heparin, direct thrombin inhibitors and oral platelet activation inhibitors provide substantial benefit, only glycoprotein (GP) IIb/IIIa inhibitors block the final common pathway leading to platelet aggregation, and the American College of Cardiology/American Heart Association guidelines recommend GP IIb/IIIa inhibitors as an integral component of care in these patients. Abciximab, eptifibatide and tirofiban all act through the GP IIb/IIIa receptor; however, variations in clinical outcomes among patients receiving these agents may be related to their structural and pharmacological differences, as well as to patient demographics. Data indicate that eptifibatide, at the current recommended dosing schedule, achieves the highest level of consistent platelet inhibition compared with current doses of abciximab and tirofiban.     

Optimal use of platelet glycoprotein IIb/IIIa receptor antagonists in patients undergoing percutaneous coronary interventions

Discovery of the central role of platelets in the pathogenesis of acute coronary syndromes (ACS) and ischaemic complications of percutaneous coronary interventions (PCI) has led to the widespread use of oral and parenteral platelet inhibitors to treat these conditions. Glycoprotein (GP) IIb/IIIa (also known as α(IIb)β(3)) receptors on the surface of platelets play an essential role in platelet aggregation and serve as a key mediator in the formation of arterial thrombus. When activated, GP IIb/IIIa receptors bind to fibrinogen, which serves as the 'final common pathway' in platelet aggregation. Of the numerous agents developed for modulating platelet activity, intravenous platelet GP IIb/IIIa receptor antagonists are the most potent. There are four agents in clinical use, including abciximab, eptifibatide, tirofiban and lamifiban, although lamifiban is not approved for use in the US. While all agents block fibrinogen binding to GP IIb/IIIa, they do so by different mechanisms. Abciximab is a humanized form of a murine monoclonal antibody directed against GP IIb/IIIa, eptifibatide is a synthetic, cyclic heptapeptide that contains a lysine-glycine-aspartic acid (KGD) sequence that mimics the arginine-glycine-aspartic acid (RGD) sequence found on GP IIb/IIIa, tirofiban is a non-peptide antagonist derived by optimization of the tyrosine analogue that structurally mimicks the RGD-containing loop of the disintegrin echistatin, and lamifiban is a synthetic, non-cyclic, non-peptide, low-molecular-weight compound. In clinical trials, use of these agents reduces ischaemic adverse cardiovascular events in patients with ACS undergoing PCI, but at a cost of increased bleeding.     

无负荷量替罗非班在老年急性冠状动脉综合征患者介入术中的应用

目的研究老年急性冠状动脉综合征（ACS）患者经皮冠状动脉介入（PCI）术中应用无负荷量替罗非班的有效性及安全性。方法将180例老年ACS患者按入院顺序随机分为替罗非班非负荷量组、负荷量组和对照组,各60例。非负荷量组PCI术中（导丝通过病变后即刻）替罗非班以0．15μg／（kg·min）的剂量维持静脉滴注24h,负荷量组PCI术中替罗非班以10μg/kg于3min内推注完毕,后0．15μg/（kg·min）的剂量维持静脉滴注24h。对照组不使用替罗非班。比较3组术中、术后血小板聚集率的水平,PCI术后即刻罪犯血管（CV）的心肌梗死溶栓试验（TIMI）血流分级,术前与术后心肌酶[肌酸激酶（CK）,肌酸激酶同T酶（CK—MB）,乳酸脱氢酶（LDH）,心肌肌钙蛋白I（cTnI）]变化,以及术后30d内的主要不良心血管事件（MACE）、术后出血的发生率。结果与对照组相比,替罗非班非负荷量组和负荷量组血小板聚集率明显下降,术后心肌酶水平明显降低,30d内的MACE事件发生率也降低[血小板聚集率：用药后12h对照组（58．5±1．5）％、非负荷量组（28．6±1．4）％、负荷量组（32．6±3．2）％,用药后24h对照组（57．9±2．3）％、非负荷量组（44．2±1．7）％、负荷量组（46．1±1．9）％;心肌酶CK—MB：对照组（16．6±3．5）U／L、非负荷量组（13．3±2．2）U／L、负荷量组（12．5±4．0）U／L;LDH：对照组（298±61）U／L、非负荷量组（245±52）U／L、负荷量组（257±48）U／L;cTnI：对照组（0．78±0．17）μg/L、非负荷量组（0．37±O．18）μg/L、负荷量组（0．28±0．23）μg/L;30d内的MACE事件发生率：3．3％（2／60）、1．7％（1／60）比13．3％（8／60）,均P〈0．05]。非负荷量组和负荷量组血小板聚集率、心肌酶水平、CV的TIMI血流分级、30d内的MACE事件、出血并发症发生率比较,差异均无统计学意义（均P〉0．05）。结论老年ACS患者介入术中使用无负荷量替岁非班,能明显降低血小板聚集率,改善CV的TIMI血流,减少不良心脏事件。