目的:评价不同维持量替罗非班治疗高危不稳定型心绞痛(UAP)的临床疗效及安全性.方法:41例已给予标化阿司匹林、氯吡格雷抗血小板治疗,低分子肝素抗凝治疗,冠心病常规治疗的高危UAP患者,行急诊冠状动脉造影检查无法进行介入治疗,仍频发心绞痛,按替罗非班维持剂量随机分为半剂量组(21例)和常规剂量组(20例),两组均给予负荷剂量替罗非班,维持剂量持续应用48 h.结果:两组总有效率均为100％,与治疗前比较,两组心电图ST段下移幅度均有明显减小[常规剂量组:(1.52±0.72) mm比(0.71±0.54) mm,半剂量组:(1.49±0.81) mm比(0.69±0.72) mm,P均＜0.01],半剂量组的不良反应(轻度出血)的发生率明显低于常规剂量组(14.3％比20.0％,P＜0.05).结论:常规或半维持剂量替罗非班治疗高危不稳定型心绞痛,均可进一步缓解心绞痛症状和改善心电图,但半剂量组不良反应较常规剂量组显著减少.%Objective: To evaluate therapeutic effects and safety of different maintenance doses of tirofiban on treatment of high-risk patients with unstable angina pectoris (UAP). Methods; After standardized antiplatelet therapy with aspirin and clopidogrel, anticoagulant therapy with low molecular heparin and routine treatment for coronary heart disease, a total of 41 high- risk UAP patients cannot receive percutaneous coronary intervention according to primary coronary angiography and they still had frequent angina pectoris. According to maintenance dose of tirofi-ban, patients were randomly divided into half dose group (n = 21) and routine dose group (n = 20). Both groups received loading dose of tirofiban at first and maintenance dose for 48h. Results: Total effective rates were 100% in both groups. Compared with before treatment, decrease extents of ST segment in electrocardiogram significantly decreased in both groups [routine dose group: (1. 52 ± 0. 72) mm vs. (0. 71 ± 0. 54) mm, half dose group: (1. 49 + 0. 81) mm vs. (0. 69± 0. 72) mm, P<0. 01 both]. Incidence rate of hyporhea in half dose group was significantly lower than that of routine dose group (14. 3% vs. 20. 0% , P<0. 05). Conclusion: Routine or half maintenance doses of tirofiban are safe and effective in improving symptoms of angina pectoris and electrocardiogram in high - risk patients with unstable angina pectoris. Hyporhea in half dose group is significantly decrease than that of routine dose group
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