替罗非班治疗急性心肌梗死的疗效和安全性观察

目的观察替罗非班治疗急性心肌梗死(AMI)与尿激酶静脉溶栓合用的安全性及疗效。方法对122例AMI患者随机分为治疗组60例,对照组62例。两组患者均给予静脉溶栓、硝酸甘油、培哚普利/或氯沙坦、美托洛尔、拜阿司匹林、氯吡格雷、阿托伐他汀钙、依诺肝素等作为基础治疗。治疗组在溶栓后静脉泵入替罗非班,先0.4μg/(kg.min)×30min,后0.15μg/(kg.min)。观察梗死血管再通、出血并发症、主要心脏不良事件(MACE)。结果梗死血管再通率治疗组比对照组显著提高,P<0.05,差异有统计学意义。出血并发症两组无统计学意义,P>0.05。MACE治疗组比对照组显著降低,差异有统计学意义(P<0.05)。结论替罗非班在治疗AMI与尿激酶静脉溶栓合用是安全有效的。

Efficiency and safety for intravenously administration of urokinase and tirofiban in treating acute myocardial infarction

Objective To assess the efficiency and safety for intravenously administration of urokinase and tirofiban for the treatment of acute myocardial infarction.Methods 122 patients with acute myocardial infarction were randomly divided into two groups.60 were in tirofiban group and 62 in basic therapy group.Patients in both groups took intravenous thrombolysis together with nitroglycerine,perindopril or losartan,metoprolol,aspirin,clopidogrel,atorvastatin calcium,enoxaparin etc.as basic medication.For patients in tirofiban group,tirofiban was additionally administrated by intravenous micro-pump with 0.4μg/(kg·min) for 30 minutes and 0.15μg/(kg·min) for maintenance after thrombolysis.Development of infarction related artery refusion,hemorrhage and major adverse cardiac events were observed and recorded.Results The infarction related artery refusion rate in tirofiban group was significantly higher than basic therapy group(P>0.05).There was no major difference in the incidence of hemorrhage between two groups(P<0.05).The development of major adverse cardiac events was significantly lower in tirofiban group than basic therapy group(P<0.05).Conclusion Intravenously administration of urokinase and tirofiban is a safe and effective treatment for AMI patients in suburban area.