盐酸替罗非班治疗急性冠脉综合征的安全性和有效性评价

目的评价盐酸替罗非班治疗急性冠脉综合征（ACS）的安全性和有效性。方法选择2009年1月～2011年12月驻马店市第一人民医院符合ACS标准的123例患者，按就诊顺序分为观察组（62例）和对照组（61例），两组同时常规应用阿司匹林、低分子肝素、氯吡格雷、阿托伐他汀、硝酸甘油治疗，观察组同时加用盐酸替罗非班治疗。比较两组患者治疗24h后肌钙蛋白T（eTnT）峰值水平，血小板计数（PLT）及凝血酶原时间（PT）、部分凝血活酶时间（APTT）；30d时主要心脏不良事件发生率、心电图ST段回落情况；不良反应及出血情况。结果治疗24h后cTnT峰值水平、30d后心电图sT段回落率在观察组分别为（1．47±0．58）μg／L、88．7％（55／62）]，与对照组f（2．34±0．49）μg/L、68．9％（42／61）]比较，差异均有统计学意义（t=3．845，x2=7．273，均P〈0．05）。治疗30d后观察组和对照组主要心脏不良事件的发生率分别为4．84％（3／62）和11．48％（7／61），两组比较差异无统计学意义（X2=1．813，P〉0．05）。两组均未出现血小板减少、少量出血和（或）大出血。结论在常规治疗的基础上采用替罗非班治疗ACS能够减少心肌细胞损伤，改善心功能，减少近期主要心脏不良事件的发生，有较好的安全性。

Evaluation on safety and effectiveness of Tirofiban in the treatment of acute coronary syndrome

Objective To explore the safety and effectiveness of Tirofiban in the treatment of acute coronary syndrome （ACS）. Methods 123 patients with ACS from January 2011 to December 2012 in the First People＇s Hospital of Zhu- madian City were divided into observation group （62 cases） and control group （61 cases） by medical order. The routine treatments such as Aspirin, Low Molecular Heparin, Clopidogrel and Atorvastatin, Nitroglycerin were performed for all the patients, while Tirofiban was administered additionally to the patients in observation group. Cardiactroponin T （cTnT） peak level in 24 hour, blood platelet count （PLT）, prothrombin time （PT）, activated partial thromboplastin time （APTT） were compared, major adverse cardiac events in 30 d, rate of fall of ST segment, adverse reactions and bleeding condition were observed in two groupsl Results After treatment of 24 h cTnT peak level, after 30 d electrocardiogram ST segment back rate in the observation group were （1.47±0.58） μg/L）, 88.7%（55/62）], compared with control group （2.34±0.49） μg/L）, 68.9%（42/61）] were significant different （t = 3.845, x2=7.273, all P 〈 0.05）. There was difference about the occurrence rates of major adverse cardiac events in 30 d in both groups： 4.84%（3/62） and 11.48%（7/61） x2= 1.813, P 〉 0.05）. There was no thrombocytopenia or bleeding even slight bleeding in either group. Conclusion Tirofiban can reduce the myocardial cell injury, improve cardiac function, reduce the recent major adverse cardiac events occur, it has better security.