替罗非班对急性冠脉综合征择期PCI术临床预后的影响

目的 观察急性冠脉综合征(ACS)患者择期PCI术后使用替罗非班对围术期不同时间点心脏标记物、血小板聚集率的变化规律以及对PCI术后半年临床疗效及预后的影响.方法 选择2009年1月至2011年12月焦作市人民医院心内科住院ACS择期PCI术患者116例,随机分为替罗非班组和对照组.两组患者术前均常规使用阿司匹林和氯吡格雷治疗,替罗非班组患者于PCI术后给予替罗非班并持续至少36 h.观察院内实验室检查结果,住院期间主要不良心脏事件(心源性死亡、再发心绞痛、再次血管重建、心肌梗死)及并发症(主要是出血)的发生情况;随访半年再入院率、主要不良心脏事件的发生情况.结果 术后6、24、48 h,替罗非班组血小板聚集率显著低于术前及对照组(P＜0.01);术后替罗非班组cTnT( 20％vs62％,P＜0.05)和CK-MB( 17％vs 56％,P＜0.05)增高均低于对照组;替罗非班组住院期间及随访6个月主要不良心脏事件发生率明显低于对照组,差异有统计学意义(P＜0.05);随访6个月替罗非班组再入院率低于对照组.结论 使用替岁非班可以明显降低血小板聚集率,减少ACS择期PCI术后心肌标记物(cTnT、CK-MB)的升高,减少患者术后住院期间及随访6个月主要不良心脏事件的发生,降低再入院率且安全性良好.

The observation of clinical prognosis in patients with acute coronary syndrome(ACS) after elective PCI using tirofiban

Objective To observe the acute coronary syndrome(ACS) in patients after elective PCI using tirofiban on perioperative cardiac markers at different time points,the changes of platelet aggregation and clinical efficacy of six months after PCI and prognosis impact.Methods From January 2009 to December 2011 People’s Hospital of Jiaozuo City hospital ACS patients undergoing elective PCI 116 cases were randomly divided into tirofiban and control groups.Two groups of patients with routine use of preoperative aspirin and clopidogrel,tirofiban after PCI given to patients in the tirofiban and for at least 36 h.Observe the hospital laboratory results,hospital major adverse cardiac events(cardiac death,recurrent angina,repeat revascularization,myocardial infarction) and complications(mainly bleeding) were investigated;follow-up six months readmission rate,major adverse cardiac events were observed.Results After 6,24,48 h,tirofiban platelet aggregation was significantly lower than the preoperative and control group(P<0.01).After tirofiban cTnT(20% vs 62%,P<0.05) and CK-MB(17% vs 56%,P<0.05) were higher than the control group,tirofiban during hospitalization and followed up for 6 months the incidence of major adverse cardiac events was significantly lower than the control group,the difference was statistically significant(P<0.05),followed up for 6 months tirofiban readmission rate lower than the control group.Conclusion Tirofiban can significantly reduce platelet aggregation,reduce elective PCI after ACS cardiac markers(cTnT,CK-MB) increases,reducing the patients during hospitalization and 6-month follow-up major adverse cardiac events reduce the readmission rate and good safety.