磺达肝癸钠对急性冠脉综合征介入治疗术后的临床分析  

Clinical analysis of Fondaparinux in Treatment of Acute Coronary Syndromes after Interventional Therapy

作　　者：杨雪松[1] 曹红涛[1] 杜云蕙[1] 唐咏[1] 喻卓[1] 

机构地区：[1]昆明医学院第一附属医院心内科,云南昆明650031

出　　处：《昆明医学院学报》2011年第6期98-100,139,共4页Journal of Kunming Medical College

摘　　要：目的观察磺达肝癸钠在急性冠脉综合征(ACS)介入治疗术后临床应用的心血管事件、详细出血情况及凝血功能,探讨其近期疗效及出血风险.方法选取2010年1月至2011年2月在昆明医学院第一附属医院心内科行经皮冠状动脉介入治疗(PCI)的103例ACS患者为研究对象,随机分为磺达肝癸钠组(2.5mg皮下注射,每日1次)和低分子肝素钙组(0.4 mL皮下注射,1次/2 h),均连用3～8 d.评价30 d时心血管事件发生情况、详细出血情况和凝血功能.结果磺达肝癸钠在降低30 d反复发作胸痛、急性左心衰和死亡的发生不劣于低分子肝素钙(19.2%比29.4%,P>0.05),出血发生率较低分子肝素钙组下降(9.6%比27.5%,P<0.5),血小板计数(PLT)、血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)在磺达肝癸钠用药前后差异无统计学意义(P>0.05).结论磺达肝癸钠治疗ACS的有效性不劣于低分子肝素钙、出血风险小,不延长PT、APTT,未发生PLT减少,值得推广应用.Objective To observe cardiac events,bleeding complications and blood coagulation function after using fondaparinux in acute coronary syndromes after interventional therapy,and explore the effect in the short term and the bleeding risks of fondaparinux.Methods 103 cases with acute coronary syndromes were selected from Jan 2010 to Feb 2011 in the 1st Affiliated Hospital of Kunming Medical University and assigned to receive either fondaparinux（2.5 mg daily or control for up to 8 days）or low molecular weight heparin calcium（0.4 mL twice daily or control for up to 8 days）.Cardiac events,bleeding and blood coagulation function were evaluated at 30 days.Results Patients with recurrent angina pectoris events,acute left heart failure events and death were similar in the two groups（with fondaparinux vs.with low molecular weight heparin calcium ,P0.05）.The rate of bleeding at 30 days was lower with fondaparinux than with low molecular weight heparin calcium（9.6% vs.27.5%,P0.05）.The results of PLT,PT and APTT were similar before and after using fondaparinux（P0.05）.Conclusions The efficacy of fondaparinux in the treatment of ACS is similar to that of low molecular weight heparin calcium and fondaparinux reduces bleeding.It doesn＇t influence PLT,PT andAPTT and is worth of popularization.

关 键 词：急性冠脉综合征 磺达肝癸钠 低分子肝素钙 经皮冠状动脉介入治疗 

分 类 号：R541.4[医药卫生—心血管疾病]