替罗非班在老年高危非st段抬高型急性冠脉综合征患者介入治疗中的作用

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1、替罗非班在老年高危非ST段抬高型急性冠脉综合征患者介入治疗中的作用［摘要］目的观察替罗非班在老年高危非ST段抬高型急性冠脉综合征（NSTE-ACS）患者介入治疗中的作用。方法选择2012年2月〜2015年2月在第三军医大学大坪医院野战外科研究所拟行经皮冠脉介入治疗（PCI）的老年高危NSTE-ACS患者320例，将其分为对照组162例（常规治疗）和观察组158例（常规治疗+替罗非班）。比较两组患者PCI治疗前后TIMI心肌灌注分级情况，分析两组患者的临床治疗效果，检测两组血小板聚集率和血小板计数，随访30d，记录两组心血管不良事件（MACE）发生率，观察出血并发症的发生

2、率。结果PCI术后观察组HMI心肌灌注水平明显优于对照组（P0.05）。结论对于老年高危NSTE-ACS患者，替罗非班能有效地改善患者TIMI心肌灌注水平，降低血小板聚集率，提高临床疗效，改善近期临床预后水平，而不增加出血风险，值得临床运用。［关键词］替罗非班；老年；经皮冠脉介入治疗；非ST段抬高型急性冠脉综合征分类号］R543.3［文献标识码］A［文章编号］1673-7210（2016）01（c）-0142-04EffectofTirofibaninthepercutaneouscoronaryinterventionofelderlypatientswithhish

3、-risknon-ST-elevationacutecoronarysyndromeCHENShijunYUHaoyueLUHuiHUJiayongADepartmentofCardiology,DapingHospitalandtheResearchInstituteofSurgeryoftheThirdMilitaryMedicalUniversity,Chongqing400042，China[Abstract]ObjectiveToobservetheeffectofTirofibaninthepercutaneouscoronaryintervention(P

4、CI)forelderlypatientswithhish-risknon-ST-elevationacutecoronarysyndrome(NSTE-ACS).MethodsThreehundredandtwentycasesofelderlypatientswithhish-riskNSTE-ACSreceivingPCIinDapingHospitalandtheResearchInstituteofSurgeryoftheThirdMilitaryMedicalUniversityfromFebruary2012toFebruary2015wereselect

5、edanddividedintotwogroupsincluding162casesofcontrolgroup(conventionaltreatment)and158casesofobservationgroup(conventionaltreatment+Tirofiban).TheTIMImyocardialperfusiongradingbeforeandafterPCIofthetwogroupswascompared,theclinicalefficacyofthetwogroupswasanalyzed,theplateletaggregationlev

6、elsandplateletcountofthetwogroupsweremeasured，theincidenceofmajoradversecardiovascularevent(MACE)wasrecordedafterafollow-upperiodof30d，andtheincidenceofbleedingcomplicationswasobserved.ResultsTheTIMImyocardialperfusiongradesafterPCIweresignificantlybetterthanthecontrolgroup(P0.05).Conclu

7、sionForelderlypatientswithhish-riskNSTE-ACS,TirofibancansignificantlyimproveTIMImyocardialperfusionlevels，reduceplateletaggregation,improveclinicalefficacyandshort-termclinicalprognosis,withoutincreasingtheriskofbleeding,whichisworthyofclinicalapplication.[Keywords]Tirofi