文章摘要
王 晖,宋 梅,薛朝阳,杨志健,朱铁兵,王连生,曹克将.糖蛋白Ⅱb/Ⅲa受体拮抗剂治疗高危急性冠脉综合征的应用时限研究[J].南京医科大学学报,2009,29(3):368~371
糖蛋白Ⅱb/Ⅲa受体拮抗剂治疗高危急性冠脉综合征的应用时限研究
Routin upstream initiation vs deferred selective use of glycoprotein IIb/IIIa inhibitors in high-risk acute coronary syndromes
投稿时间:2008-11-19  
DOI:10.7655
中文关键词: 血小板膜糖蛋白Ⅱb/Ⅲa拮抗剂  高危不稳定型心绞痛/非ST段抬高心肌梗死  早期治疗
英文关键词: glycoprotein Ⅱb/Ⅲa inhibitors  high-risk acute coronary syndromes  upstream initiation
基金项目:
作者单位
王 晖 南京医科大学第一附属医院心脏科,江苏 南京 210029 
宋 梅 银川市第一人民医院心脏科,宁夏 银川 750001 
薛朝阳 银川市第一人民医院心脏科,宁夏 银川 750001 
杨志健 南京医科大学第一附属医院心脏科,江苏 南京 210029 
朱铁兵 南京医科大学第一附属医院心脏科,江苏 南京 210029 
王连生 南京医科大学第一附属医院心脏科,江苏 南京 210029 
曹克将 南京医科大学第一附属医院心脏科,江苏 南京 210029 
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中文摘要:
      目的:探讨接受早期介入治疗的高危急性冠脉综合征(ACS)患者,血小板膜糖蛋白(GP) Ⅱb/Ⅲa受体拮抗剂的最佳应用时机?方法:选择接受早期冠脉介入治疗(PCI)的高危不稳定型心绞痛/非ST段抬高心肌梗死(UA/NSTEMI)患者162例,按替罗非班使用时机分常规早期治疗组和延期选择性治疗组,分别评估两种治疗方案对PCI术前?术后心肌组织水平灌注和30天复合心血管事件发生率的影响?结果:PCI术前TMPG分级0~1级患者共65例(40.1%),其中早期治疗组27例(32.9%),延期治疗组38例(47.5%);统计显示早期治疗组PCI术前TMPG分级0~1级发生率显著低于延期治疗组(P < 0.05)?30天复合心血管事件及出血发生率两组无差异(P > 0.05)?结论:GP Ⅱb/Ⅲa拮抗剂早期治疗能改善PCI术前心肌微循环,提高组织水平灌注?
英文摘要:
      Objective:To determine the optimal strategy for the use of glycoprotein Ⅱb/Ⅲa(Gp Ⅱb/Ⅲa) inhibitors in patients with high-risk acute coronary syndromes(ACS) receiving an early invasive treatment. Methods:One hundred and sixty-two patients with high-risk ACS undergoing early percutaneous coronary syndromes were assigned to receive either routine upstream(n = 82) or deferred selective(n =80) Gp Ⅱb/Ⅲa inhibitor treatment. The authors evaluated the effects of two strategies on tissue-level perfusion using the TIMI myocardial perfusion grade(TMPG) before and immediately after PCI. Blooding complications and the 30 day composite end point events were also evaluated. Results:Among all the total 162 patients, the TMPG 0-1 perfusion were observed in 65 patients(40.1%). The TMPG 0-1 perfusion was significantly less frequent in routine upstream treatment(n = 27) than in deferred selective group(n = 38) before PCI(32.9% vs 47.5%, respectively; P < 0.05). No differences were seen both in 30 day composite end point events and bleeding complications. Conclusion:Among high-risk ACS patients treated with an early invasive strategy, routine upstream use of Gp Ⅱb/Ⅲa inhibitors is associated with tissue-level perfusion improved and without bleeding complications increased.
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