替罗非班对老年急性冠脉综合征患者行PCI术的疗效及安全性分析

目的探讨血小板膜糖蛋白（GP）Ⅱb／Ⅲa受体拮抗剂替罗非班（tirofiban）对老年急性冠脉综合征患者行经皮冠状动脉介入治疗的疗效及安全性。方法选择2007年3月至2007年1275入院并明确诊断为ACS的患者53例，行PCI术并联合应用替罗非班治疗，按照年龄≥65岁和〈65岁将其分为老年组25例和非老年组28例。观察两组患者应用替罗非班后乳酸脱氢酶、肌酸激酶同工酶、肌钙蛋白及凝血指标的改变与血小板减少症、住院期间出血事件的发生情况。结果PCI术后联合应用替罗非班均可减轻两组患者的心肌损伤程度，LDH、CK—MB、cTnI较术前均显著降低（P〈0．01）；住院期间老年组患者凝血指标的改变和出血事件的发生率有高于非老年组的趋势，但两组间的安全谱无显著性差异（P〉0．05）。结论PCI术后联合替罗非班治疗对老年急性冠脉综合征患者是安全有效的，并不明显增加出血并发症的发生。

Investigation of the Efficacy and Safety of Tirofiban in Elderly Patients with Acute Coronary Syndromes Referred to Percutaneous Coronary Intervention

Objective To investigate the efficacy and safety of platelet membrane glycoprotein Ⅱb/Ⅲa receptor inhibitor tirofiban in elderly patients with acute coronary syndromes （ACS） referred to percutaneous coronary intervention （PCI）. Methods 53 patients who suffered from ACS and underwent PCI surgery therapied with tirofiban were selected during March 2007 and December 2007 period,those patients were divided into：elderly group （25 cases,aged 65 years or older）, non-elderly group （28 cases,younger than 65 years）. LDH, CK-MB, cTnI, coagulation index, thrombocytopenia,the incidence of bleeding complications were observed and analyzed retrospectively during the hospital days. Results Tirofiban could lessen myocardial injury,which decreased LDH,CK-MB,cTnI significantly after PCI surgery in two groups（P〈0.01）; coagulation index and the minor incidence of bleeding complications in elderly group were higher than the non-elderly group, but there was no significant differences between the two groups （P〉0.05）. Conclusion Application of GP Ⅱb/Ⅲa inhibitor tirofiban can benefit the elderly patients with ACS referred to PCI therapy with minimal risk of bleeding complications.