氨甲环酸与半量抑肽酶在非体外循环冠状动脉搭桥术的作用比较  

Tranexamic Acid and Half Dose Aprotinin in Off-Pump Coronary Artery Bypass

作　　者：郭志鹏[1] 简锴陶[1] 魏民新[1] 郭志刚[1] 李培军[1] 韩建阁[1] 文其祥[1] 蔡忠[1] 

机构地区：[1]天津市胸科医院心脏外科,300051

出　　处：《中国循环杂志》2007年第6期455-458,共4页Chinese Circulation Journal

基　　金：天津市科委科研基金资助(基金编号:05YFSZSF02700)

摘　　要：目的:评估氨甲环酸和半量抑肽酶在非体外循环冠状动脉搭桥术(OPCAB)的止血作用。方法:112例 OPCAB 患者随机分为3组,分别接受半量抑肽酶(抑肽酶组,n=36)、氨甲环酸(氨甲环酸组,n=36)或等量生理盐水(对照组,n=40)。记录术后出血量、输血情况以及其他相关临床指标。结果:抑肽酶组及氨甲环酸组术后出血量较对照组明显减少(P<0.05)。抑肽酶组和氨甲环酸组术后 D-二聚体水平的升高受到明显抑制(P<0.05)。各组围术期血小板计数和黏附率未见显著变化。结论:在 OPCAB 中应用半量抑肽酶和氨甲环酸是安全的,二者有相近的抗纤溶作用,均能明显减少术后出血、抑制纤溶亢进,但不影响术后血小板功能。Objectives ： To evaluate the hemostatic effects of tmnexamic acid and half dose aprotinin in patients undergoing off-pump coronary artery bypass （OPCAB）. Methods - One hundred and twelve patients were randomized into three groups; half dose aprotinin, tranexamic acid or saline solution. Perioperative hematochemical parameters including platelet adhesion rate, D-dimer, were observed. Postoperative blood loss, blood transfusion and other clinical data were recorded. Results： Cumulative blood loss during at 6 h and 24 h was significantly reduced in patients treated with apmtinin or tranexamic acid （P 〈 0. 05 ）. Levels of D-dimer were raised after surgery, but significantly lower in aprotinin and tranexamic acid groups as compared to the controls （P 〈 0.05 ）. Platelet adhesion rate in all groups had no significant changes at perioperation （P 〉0. 05）. Conclusion： The present results show that half-dose aprotinin and tranexamic acid have similar hemostatic effect in patients undergoing OPCAB.

关 键 词：氨甲环酸 抑肽酶 非体外循环冠状动脉搭桥术 D-二聚体 血小板黏附率 

分 类 号：R541[医药卫生—心血管疾病]