替罗非班对急性冠状动脉综合征患者肝剂量及血小板的影响

目的：探讨对急性冠状动脉综合征患者在常规治疗基础上联合替罗非班强化抗血小板治疗对肝素抗凝剂量及血小板数量和功能的影响。资料和方法：选择因急性冠状动脉综合征入院的患者共64例，分为双联抗血小板和肝素抗凝的常规治疗组(n=36)和在此基础上联合使用替罗非班组(n=28)，以达到肝素抗凝使激活的部分凝血时间延长2倍为标准，比较两组肝素使用剂量、ADP诱导的血小板聚集率及血小板数量变化情况。结果：替罗非班组肝素用量（500±120U/h）显著低于常规组(760±148U/h, P<0.01)，用药后两组的血小板聚集率均显著低于用药前(P<0.01)，但替罗非班组降低更显著(P<0.01)，替罗非班组用药后血小板降低(P<0.05)。结论：联合应用替罗非班可降低肝素抗凝剂量，显著抑制血小板聚集活性，并呈降低降低血小板数量的趋势。

effect of tirofiban on dose of heparin and platelet aggregation in patients with acute coronary artery syndrome

Objectives: To explore the effects of tirofiban on the dose of heparin and aggregation of platelets in the patients with acute coronary artery syndrome. Methods: Sixty-four patients with acute coronary artery syndrome were divided into controlled group (n=36) and tirofiban group (n=28). Conventional therapies of anti-platelets with aspirin and clopidogrel and anti-coagulation with unfractional heparin were used in controlled group. Tirofiban plus the conventional therapies were used in tirofiban group. The dose of heparin was adjusted to maintain the actived coagulation time to 2 times prolongation. The dose of heparin, aggregation rate of platelets induced by adenosine diphosphate and platelets count were compared between the two groups. Results: The dose of heparin was significant lower in tirofiban group than in controlled (500±120U/h vs 760±148U/h, P<0.01). Aggregation rate of platelets was decreased after 24h of treatments in the two groups (P<0.01) but was more remarkable in tirofiban group (P<0.01). The platelets number was significant decreased in tirofiban groups after 24h of the treatment (P<0.05). Conclusion: Addition to the conventional therapies with anti-platelets and anti-coagulation, tirofiban reduced the dose of heparin, inhibite aggregation of platelets and decrease platelets number.