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目的:探讨不同剂量替罗非班联合冠脉介入治疗对非ST段抬高型急性冠脉综合征(Non ST-segment elevation acute coronary syndromes,NST-ACS)的疗效及安全性。方法:选择我院2014年10月至2016年6月收治的110例NST-ACS患者,根据随机数字表法,分为全剂量组及半剂量组。观察两组患者治疗前后的TIMI血流分级情况、术前及术后30 d的心功能、主要心血管事件及出血事件、住院费用及住院天数。结果:与术前相比,两组的TIMI 2级和3级血流分级显著降低;术后30 d两组患者的左室收缩末期容积(left ventricular end diastolic volume,LVEDV)、左室舒张末期容积(left ventricular end systolic volume,LVESV)均明显下降,而左室射血分数(left ventricular ejection fraction,LVEF)均明显上升,P均<0.05;而术前、术后组间TIMI血流分级、LVEDV、LVESV及LVEF对比无统计学意义,两组的主要心血管事件及住院时间对比差异无统计学意义,P均>0.05;而全剂量组组的出血事件及住院费用对比明显高于半剂量组,P<0.05。结论:半剂量组的替罗非班联合冠脉介入治疗对NST-ACS疗效显著,且可降低患者的出血事件及住院费用,值得临床推广应用。
Objective: To investigate the efficacy and safety of different doses of tirofiban in combination with coronary intervention for non ST-segment elevation acute coronary syndromes (NST-ACS). Methods: A total of 110 patients with NST-ACS admitted to our hospital from October 2014 to June 2016 were randomly divided into full-dose and half-dose groups. TIMI grade before and after treatment, cardiac function, major cardiovascular events and bleeding events, hospitalization costs and days of hospitalization were observed before and after treatment. Results: Compared with preoperative, TIMI grade 2 and grade 3 blood flow grades were significantly decreased in both groups. Left ventricular end diastolic volume (LVEDV), left ventricular end-diastolic volume Left ventricular end systolic volume (LVESV) were significantly decreased, and left ventricular ejection fraction (LVEF) were significantly increased, P <0.05; and preoperative and postoperative TIMI flow classification, LVEDV, LVESV and LVEF had no statistical significance. There was no significant difference in major cardiovascular events and hospital stay between the two groups (P> 0.05). The bleeding and hospitalization costs in the full-dose group were significantly higher than those in the half-dose group Group, P <0.05. Conclusion: Tirofiban combined with coronary intervention in the half-dose group has significant effect on NST-ACS and can reduce the bleeding and hospitalization costs in patients. It is worthy of clinical application.