急性冠脉综合征PCI后取消负荷量静注仅小剂量应用替罗非班的研究

发布时间：2018-08-14 14:41

【摘要】：目的比较急性冠脉综合征行急诊PCI后,取消负荷量而直接静脉小剂量维持应用替罗非班与常规应用是否具有相同的降低心血管事件的发生率的作用,且减少出血并发症的发生。方法选择行急诊PCI术且术后应用替罗非班的急性冠脉综合征的病人,分为常规剂量与小剂量组;病人术后按常规剂量泵入替罗非班(首先以10μg/kg静脉1-3 min内推注,继之以0.15μg/(kg·min)维持静脉泵入36 h);小剂量组未给予负荷剂量直接静脉小剂量替罗非班泵入,以0.15μg/(kg·min)维持静脉泵入36 h;观察两组患者院内死亡率、再发心肌梗死率、出血率。结果两组院内心源性死亡率无显著差异(P=0.492);院内再发梗死率无显著差异(P=0.721)。小剂量组轻度出血率明显低于常规剂量组(P=0.001),重度出血率明显低于常规剂量组(P=0.035)。结论急性冠脉综合征行急诊PCI术,不给予负荷量而直接静脉小剂量维持应用替罗非班与常规应用替罗非班对病人降低心血管事件发生率效果相当,且明显降低出血风险。
[Abstract]:Objective to compare whether tirofiban has the same effect on reducing the incidence of cardiovascular events and reducing the incidence of hemorrhage complications after emergency PCI in patients with acute coronary syndrome (ACS). Methods patients with acute coronary syndrome (ACS) who underwent emergency PCI and were treated with tirofiban were divided into two groups: routine and low dose groups, and were pumped into tirofiban (10 渭 g/kg intravenous 1-3 min) after operation. Then, 0.15 渭 g / (kg min) was injected into the low dose group for 36 h); without loading dose, and 0.15 渭 g / (kg min) for 36 h. The hospital mortality, recurrent myocardial infarction rate and bleeding rate of the two groups were observed. Results there was no significant difference in cardiac mortality between the two groups (P0. 492), but there was no significant difference in the rate of recurrent infarction in the hospital (P0. 721). The rate of mild hemorrhage in the low dose group was significantly lower than that in the conventional dose group (P0. 001), and the severe bleeding rate in the low dose group was significantly lower than that in the conventional dose group (P0. 035). Conclusion PCI is effective in reducing the incidence of cardiovascular events and reducing the risk of hemorrhage in patients with acute coronary syndrome treated with direct intravenous low-dose tirofiban without loading and routine use of tirofiban.
【作者单位】：吉林市中心医院心脏中心;吉林市新农合管理中心;Rutgers
【分类号】：R541.4

【相似文献】