替罗非班在非ST段抬高型急性冠脉综合征患者中的临床应用价值

目的 观察早期使用血小板膜糖蛋白（GP）Ⅱb/Ⅲa受体拮抗剂（替罗非班）对非ST段抬高型急性冠脉综合征（NSTE-ACS）患者疗效及安全性.方法 选取我院2010年1月～2012年12月诊断为NSTE-ACS的患者2000例,按是否使用替罗非班为标准分为替罗非班组（713例）和对照组（1287例）,分别比较两组的临床基线特征、两组患者在住院期间心血管事件发生率（全因死亡、顽固性心绞痛、再发心肌梗死）;心肌梗死1周后左室舒张末期内径及射血分数、梗死相关动脉无复流的发生率、PCI术后罪犯血管TIMI3级血流发生率、住院时间、血小板减少发生率、严重出血事件.结果 两组患者顽固性心绞痛发生率、再发心肌梗死发生率、心肌梗死1周后左室射血分数、术后TIMI3级血流发生率、梗死相关动脉无复流的发生率比较,差异均有统计学意义（P＜0.05）.住院时间、出血事件及血小板减少的发生率比较差异无统计学意义（P＞0.05）.结论 针对NSTE-ACS患者使用替罗非班可有效降低住院期间心血管事件的发生,改善TIMI血流,且不增加血小板减少及大出血的发生.

The value of tirofiban in non ST-elevation acute coronary syndrome

Objective To observe the efficacy and security of early applying platelet membrane glycoproteins（GP） I1 b! HI a receptor antagonist（tirofiban） in non ST-elevation acute coronary syndrome （NSTE-ACS）. Method From Jan 2010 to Dec 2012,2000 cases of NSTE-ACS patients were randomly divided into tirofiban group（713 cases） and control group（ 1287 case） by whether applying tirofiban or not. Baseline clinical characteristics, incidence of cardiovascular events, left ventricular end-diastolic diam- eter and left ventricular ejection fraction 1 week after myocardial infarction, the occurrence of no reflow in Infarction related artery, the TIMI3 grade blood flow rate of criminal vessel after PCI, hospital stays, inci- dence of thrombocytopenia and serious bleeding events were compared between the two groups. Result The incidence of cardiovascular events,left ventricular end-diastolic diameter and left ventricular ejection fraction 1 week after myocardial infarction, the occurrence of no reflow in Infarction related artery and the TIMI3 grade blood flow rate between the two groups showed significantly difference. The hospital stays, in- cidence of thrombocytopenia and serious bleeding events between the two groups showed no difference. Conclusion Early applying tirofiban in non ST-elevation acute coronary syndrome（NSTE-ACS） may de- creasing the incidence of cardiovascular events,improving TIMI blood flow and may not increasing the in- cidence of thrombocytopenia and serious bleeding. Key words] Tirofiban; Non ST-elevation acute coronary syndrome