Objective To observe the curative effect of tirofiban hydrochloride on non-ST-elevation acute coronary syndrome ( NSTE-ACS ) and its safety. Methods The patients with unstable angina ( UA ) and non-ST-elevation myocardial infarction ( n = 164 ) were randomly divided into observation group ( n = 82 ) and control group ( n = 82 ). The control group was given aspirin, low molecular weight heparin ( LMWH ) and clopidogrel, and observation group was added tirofiban hydrochloride[ intravenous loading dosage:0.4 μg/( kg ? Min ) for 30 min and then maitining ( 0. 1 μg/ ( kg ? Min ) for 48 hours to 120 hours ]. The occurrence of major adverse cardiovascular events ( MACE ) and adverse reactions were observed in two groups 36 hours and 30 days after the treatment. Results The occurrence rate of MACE in observation group was 2. 4% after 36 hours and 6. 1% after 30 days, and in control group, 12. 2% and 18. 5%. The differences in occurrence rate of MACE in two groups were all statistically significant after 36 hours and after 30 days ( all P <0. 05 ). The occurrence rate of bleeding was 9. 8% in observation group and 6. 1% in control group and the difference was not statistically significant ( P >0. 05 ). There was no severe bleeding complication and thrombocytopenia in two groups. Conclusion Routine medications combining tirofiban hydrochloride can reduce the occurrence rate of MACE, but increased that of mild bleeding in patients with NSTE-ACS.%目的 观察盐酸替罗非班治疗非ST段抬高急性冠脉综合征(NSTE-ACS)的临床疗效及安全性.方法 入选不稳定型心绞痛及非ST段抬高心肌梗死患者164例,随机分为观察组(n=82)和对照组(n=82).对照组给予阿司匹林、低分子肝素、氯吡格雷等常规治疗;观察组在常规治疗基础上加用盐酸替罗非班[静脉负荷量0.4 μg/(kg·min),30 min后以0.1 μg/(kg·min)维持,持续48～120 h].观察两组患者治疗36 h及30 d后的主要不良心血管事件(MACE)及不良反应的发生情况.结果 观察组治疗36 h及30 d后的MACE发生率分别为:2.4%和6.1%对照组分别为:12.2%和18.5%,两组患者36 h及30 d MACE发生率差异均有统计学意义(P均＜0.05).观察组与对照组出血发生率分别为:9.8%、6.1%,差异无统计学意义(P＞0.05).两组均无严重的出血并发症及显著血小板减少.结论 NSTE-ACS患者在常规药物基础上联用盐酸替罗非班治疗可减少MACE的发生率,但增加轻微出血的发生率.
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