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《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:

2012年第1期

页码:

67-70

栏目:

临床研究

出版日期:

2012-02-25

文章信息/Info

Title:

Effects of tirofiban on high-sensitivity C-reactive protein and fibrinogen in non-ST-segment elevation acute coronary syndrome patients with medium-risk diabetes

作者:

李 岚¹; 姜述斌¹; 帕尔哈提¹; 赵勤英²; 徐风燕¹; 张宝简¹; 毛拉提¹

(1.新疆医科大学附属中医医院心脏中心CCU，新疆 乌鲁木齐 830000；2.新疆民政康复医院，新疆 乌鲁木齐 830094)

Author(s):

LI Lan¹;  JIANG Shu-bin¹;  PA Er-ha-ti¹;  ZHAO Qin-ying²;  XU Feng-yan¹;  ZHANG Bao-jian¹;  MAO La-ti¹

(1.Center of Cardiology, Hospital of Traditional Chinese Medicine, Xinjiang Medical University, Urumuqi 830000, Xinjiang, China; 2.Civil Administration Rehabilitation Hospital of Xinjiang, Urumuqi 830094, Xinjiang, China)

关键词:

替罗非班; 非ST段升高急性冠脉综合征; 纤维蛋白原; 超敏C反应蛋白

Keywords:

tirofiban;  non-ST-segment elevation acute coronary syndrome;  fibrinogen;  high-sensitive C-reactive protein

分类号:

R541.4

DOI:

-

文献标识码:

A

摘要:

目的:探讨盐酸替罗非班对糖尿病中危非ST段升高急性冠脉综合征(ACS)患者超敏C反应蛋白(hs-CRP)和纤维蛋白原（FIB）的影响。方法: 选择住院非ST段升高的ACS患者248例，其中观察组129例，对照组119例，所有患者均首剂服用阿司匹林300mg、氯吡格雷300mg，之后阿司匹林100mg/d、氯吡格雷75mg/d，在此基础上观察组患者给予静脉输注盐酸替罗非班2～3 d，给予替罗非班期间连用皮下注射低分子肝素（依诺肝素：40 mg/12h），停止注射盐酸替罗非班12 h后，继续皮下注射低分子肝素3～4 d［依诺肝素：1 mg/(kg·12h）］；对照组患者用低分子肝素［依诺肝素：1 mg/（kg·12h）］皮下注射连续使用5～7 d。测定患者治疗前、治疗后7、30和60 d血浆hs-CRP和FIB并分析其相关性；观察两组中治疗后30 d、60 d内死亡、非致死性心肌梗死、复发性胸痛例数；出血状况。结果: 通过治疗两组hs-CRP和FIB水平均逐渐下降。观察组于治疗后7 d hs-CRP和FIB水平开始低于对照组，30 d降低作用最显著，60 d两组hs-CRP和FIB水平差异消失；两组hs-CRP和FIB水平变化呈线性正相关；观察组30 d 和60 d的复合缺血事件明显低于对照组；两组临床均无无明显出血事件发生。结论： 替罗非班可进一步降低中危ACS伴糖尿病患者的hs-CRP和FIB水平；降低复合缺血事件发生的同时并不增加临床出血事件发生。

Abstract:

AIM:To explore effects of tirofiban on high-sensitivity C-reactive protein (hs-CRP) and fibrinogen (FIB) in non-ST-segment elevation acute coronary syndromes (STE ACS) patients with medium risk diabetes. METHODS: A total of 248 cases of hospital patients with non-STE ACS were assigned to two groups: 129 cases in observation group and 119 cases in control group. Aspirin (300 mg) and clopidogrel (300 mg) were given as initial dose and afterwards aspirin (100 mg/day) and clopidogrel (75 mg/day) as treatment dose. In observation group, tirofiban was additionally given IVI for 2-3 days, together with hypodermic injection of low molecular weight heparin (LMWH) (enoxaparin) 40 mg/12 h. Twelve hours after tirofiban injection suspension, hypodermic injection of LMWH alone was given for another 3-4 days. In control group, hypodermic injection of LMWH ［enoxaparin 1 mg/(kg·12 h)］ was given for 5-7 days. Patients’ plasma hs-CRP, FIB and correlation were also examined before and 7, 30 and 60 days after treatment. Deaths, nonfatal MI, recurrent chest pain and bleeding conditions were also observed 30 and 60 days after treatment. RESULTS: hs-CRP and FIB levels decreased in both groups. hs-CRP and FIB levels in observation group became lower than those in control group 7 days after treatment. This difference was most significant 30 days after treatment but disappeared 60 days after treatment. hs-CRP and FIB levels in both groups presented a linear positive correlation. Composite ischemic event incidence in observation group was lower than that in control group 30 and 60 days after treatment and no major bleeding events occurred in either group. CONCLUSION: Tirofiban further reduces hs-CRP and FIB levels and lowers composite ischemic event and major bleeding events in non-STE ACS patients with medium-risk diabetes.

参考文献/References

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备注/Memo

备注/Memo:

收稿日期：2011-05-31.通讯作者：帕尔哈提，主任医师，主要从事心血管危重症抢救研究 Email:peht324@sina.cn 作者简介：李岚，副主任医师，硕士 Email:Lilan1013@126.com

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更新日期/Last Update: 2012-02-14