不同维持量替罗非班治疗高危不稳定型心绞痛患者的疗效

目的：评价不同维持量替罗非班治疗高危不稳定型心绞痛（UAP）的临床疗效及安全性。方法：41例已给予标化阿司匹林、氯吡格雷抗血小板治疗,低分子肝素抗凝治疗,冠心病常规治疗的高危UAP患者,行急诊冠状动脉造影检查无法进行介入治疗,仍频发心绞痛,按替罗非班维持剂量随机分为半剂量组（21例）和常规剂量组（20例）,两组均给予负荷剂量替罗非班,维持剂量持续应用48h。结果：两组总有效率均为100%,与治疗前比较,两组心电图ST段下移幅度均有明显减小[常规剂量组：（1.52±0.72）mm比（0.71±0.54）mm,半剂量组：（1.49±0.81）mm比（0.69±0.72）mm,P均〈0.01],半剂量组的不良反应（轻度出血）的发生率明显低于常规剂量组（14.3%比20.0%,P〈0.05）。结论：常规或半维持剂量替罗非班治疗高危不稳定型心绞痛,均可进一步缓解心绞痛症状和改善心电图,但半剂量组不良反应较常规剂量组显著减少。

Therapeutic effects of different maintenance doses of tirofiban on treatment of high-risk patients with unstable angina pectoris

Objective:To evaluate therapeutic effects and safety of different maintenance doses of tirofiban on treatment of high-risk patients with unstable angina pectoris(UAP).Methods:After standardized antiplatelet therapy with aspirin and clopidogrel,anticoagulant therapy with low molecular heparin and routine treatment for coronary heart disease,a total of 41 high-risk UAP patients cannot receive percutaneous coronary intervention according to primary coronary angiography and they still had frequent angina pectoris.According to maintenance dose of tirofiban,patients were randomly divided into half dose group(n=21) and routine dose group(n=20).Both groups received loading dose of tirofiban at first and maintenance dose for 48h.Results:Total effective rates were 100% in both groups.Compared with before treatment,decrease extents of ST segment in electrocardiogram significantly decreased in both groups [routine dose group:(1.52±0.72) mm vs.(0.71±0.54) mm,half dose group:(1.49±0.81) mm vs.(0.69±0.72) mm,P<0.01 both].Incidence rate of hyporhea in half dose group was significantly lower than that of routine dose group(14.3% vs.20.0%,P<0.05).Conclusion:Routine or half maintenance doses of tirofiban are safe and effective in improving symptoms of angina pectoris and electrocardiogram in high-risk patients with unstable angina pectoris.Hyporhea in half dose group is significantly decrease than that of routine dose group