那些病人能从获益课件.ppt

文档介绍：那些病人能从GPIIb/IIIaInhibitors获益中国医学科学院北京协和医学院心血管病研究所阜外心血管病医院袁晋青主要内容CharacteristicsofGPIIb/IIIaInhibitorsGPIIb/IIIaInhibitorsinACSGPIIb/IIIaInhibitorsinSTEMIGPIIb/IIIaInhibitorsandPCI一、CharacteristicsofGPIIb/IIIaInhibitorsGPIIb/IIIaInhibitorsAbciximabEptifibatideTirofibanTopolE,;353:227-N–SO2–C4H9OCOOHHNFabfragmentofachimericmonoclonalantibodyMW50,000DNonpeptidetyrosinederivativeMW500DCyclicheptapeptideMW800D鼠源性单克隆抗体合成非肽类合成肽类三种静脉GPⅡb/Ⅲ;80(4A):2B-(道尔顿)5000800500GPⅡb/Ⅲ:1100:1100:1血浆半衰期10---(输注血小板)较强(停药)较强(停药)出血发生率多较少较少血小板减少症相对较多少少安全性相对较差相对较好相对较好价格昂贵相对较低相对较低适应症(FDA)PCIACS;PCIACS;PCI三种静脉GPⅡb/Ⅲa受体抑制剂的比较二、GPIIb/IIIaInhibitorsinACS20%15%10%5%0%1020300DaysPRISM-PLUS(n=1,570)GPIIb/IIIaInhibitorsinACSThePrism-;338:1488-97-DeathorMIat30days-%Tirofiban+%[,]P=%15%10%5%0%1020300DaysPURSUIT(n=9,461);339:436-%Eptifibatide+%[,]P=%%%%0%5%10%15%20%PCI<72h(n=1228)NoearlyPCI(n=8233)HeparinEptifibatide+HeparinImpactofEarlyPCIon30DayDeath/%%%%0%5%10%15%PCI<72h(n=287)NoearlyPCI(n=1283)HeparinTirofiban+HeparinPRISMPlusPURSUIT31%6%42%23%