那些病人能从GPIIbIIIaInhi四bitors获益.ppt

* * * This slide from PRISM-PLUS demonstrates that significantly more patients in the tirofiban-plus-heparin group had TIMI-3 flow, and significantly fewer had TIMI-2 flow, TIMI-1 flow, or no perfusion.1 1. Zhao X-Q, Theroux P, Snapinn S, Sax F for the PRISM-PLUS Investigators. Intracoronary thrombus and platelet glycoprotein IIb/IIIa receptor blockade with tirofiban in unstable angina or non-Q-wave myocardial infarction. Angiographic results from the PRISM-PLUS trial. Circulation. 1999;100:1609-1615. * 常用的有三种静脉GPⅡb/Ⅲa受体拮抗剂，单克隆抗体阿昔单抗（abciximab）；肽类抑制剂埃替非巴肽（eptifibatide）以及非肽类抑制剂替罗非班（tirofiban），国内目前仅有替罗非班。在常规抗血小板和抗凝治疗的基础上应用GPIIb/IIIa拮抗剂对于进行PCI的患者获益最明显。在非常规进行介入治疗研究的荟萃分析显示GPⅡb/Ⅲa受体拮抗剂使死亡率和心肌梗死的危险中等程度下降，其中未进行血运重建治疗患者的获益不确切。 STEMI急性期溶栓治疗中，联合应用GPIIb/IIIa受体拮抗剂和全剂量纤溶药物可提高再灌注率，但出血风险也增加。GPIIb/IIIa受体拮抗剂联合半剂量纤溶药物发现，联合治疗可增加再通率，使再梗死绝对减少1.2％，但对30天和1年的死亡率几乎没有影响。联合用药组的严重出血明显高于单纯纤溶治疗组，尤其是高龄患者。GPIIb/IIIa受体拮抗剂是一类较强的抗血小板药物，但其出血并发症发生率明显较高，应该充分平衡患者的获益和风险。 * * This is the Sample Column Charts slide. To create this particular slide, copy and paste the sample in the Slide Sorter view as follows: Select View / Slide Sorter Highlight the Sample Column Charts page and select Edit / Copy Place the courser where you want the new slide to be and select Edit / Paste Double-click on the pasted-in slide to return to Slide view To access the column chart, right/click on the chart and select chart object / open from the menu. This will open the chart in Microsoft Graph. You can make any changes to the chart and spreadsheet here. When you are finished making your changes, select File / Exit and return to… from the menu bar. THIS METHOD IS PREFERRED TO DOUBLE-CLICKING THE GRAPH AND OPENING IT IN POWERPOINT. Double-clicking the graph can sometimes reformat the sizes, colors, animations and fonts in your graph. * Primary Endpoint - Death, MI or Urgent Intervention at 30 Days The primary endpoint of each trial was the incidence of death, MI or urgent intervention at 30 days. MI was defined a