论文部分内容阅读
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。
Objectives To compare the effect of direct intravenous low-dose maintenance with tirofiban and routine use on the incidence of cardiovascular events after acute PCI in patients with acute coronary syndromes and to reduce the incidence of bleeding complications . Methods Patients undergoing emergency PCI and with Tirofiban after acute coronary syndrome were divided into conventional and low-dose groups. Patients were treated with tirofiban at the usual dose (10 μg / kg intravenous 1-3min bolus injection, followed by 0.15μg / (kg · min) to maintain the intravenous infusion of 36h); small dose group was not given the loading dose direct intravenous low-dose tirofiban pumped to <0.15μg / (kg · min) for 36 h. The in-hospital mortality, recurrent myocardial infarction and hemorrhage were observed in two groups. Results There was no significant difference in hospital cardiac mortality between the two groups (P = 0.492). There was no significant difference in the rate of recurrent infarction in hospital (P = 0.721). The rate of mild bleeding in the low dose group was significantly lower than that in the conventional dose group (P = 0.001), and the rate of severe bleeding was significantly lower than that in the conventional dose group (P = 0.035). Conclusions Emergency PCI in patients with acute coronary syndrome undergoing PCI without maintenance dose of direct intravenous low dose of tirofiban and conventional use of tirofiban can reduce the incidence of cardiovascular events significantly and reduce the risk of hemorrhage.