比伐芦定在颈动脉狭窄支架置入术中疗效及安全性研究  

Effectiveness and safety of bivalirudin for patients with carotid artery stenosis during carotid artery stenting

作　　者：李巍[1] 杜大勇[1] 王芳[1] 柳杨[1] 薛毅 江枫[1] 李沫言[1] 李运田[1] Li Wei;Du Dayong;Wang Fang;Liu Yang;Xue Yi;Jiang Feng;Li Moyan;Li Yuntian(Department of Cardiology,305 Hospital of PLA,Beijing 100017,China)

机构地区：[1]解放军305医院心内科,北京100017

出　　处：《中国循证心血管医学杂志》2018年第7期866-869,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的探讨比伐芦定对颈动脉狭窄患者支架置入术中抗凝血作用、临床疗效及安全性。方法选取2016年1月~2017年8月于解放军第305医院心内科诊断为颈动脉狭窄患者46例,按随机数字表法分组,观察组23例,术中应用比伐芦定进行抗凝治疗,对照组23例,术中应用普通肝素注射液进行抗凝治疗,比较两组凝血指标[活化凝血时间(ACT)、活化部分凝血活酶时间(APTT)]、临床疗效及不良反应情况。结果观察组和对照组颈动脉支架置入术手术成功率均为100.0%(P>0.05),差异无统计学意义。术前、给药5 min、术毕即刻两者ACT、APTT监测结果差异亦无统计学意义(P>0.05)。停药30 min、2 h比伐芦定组ACT、APTT值迅速下降,与普通肝素组相比差异具有统计学意义(P<0.05)。对照组患者轻度出血3例,严重出血1例,总出血率为17.39%(4/23)。观察组患者总出血率为4.35%(1/23),均为轻度牙龈出血,无严重出血,观察组总出血率低于对照组,差异有统计学意义(P<0.05)。结论比伐芦定在颈动脉狭窄患者支架置入术中抗凝血效果显著,半衰期短,且不良反应较少。Objective To investigate the clinical efficacy and safety of bivalirudin in the treatment of patients with carotid artery stenosis during carotid artery stenting(CAS).Methods A total of 46 patients with carotid artery stenosis in 305 Hospital of PLA were divided into the observation group and the control group by random number table,23 cases in each group.The control group was treated with heparin anticoagulant therapy,while the observation group was given bivalirudin.The activated clotting time(ACT),activated partial thromboplastin time(APTT),procedural success rate and bleeding rate between two groups were observed.Results 30 minutes,and 2 hours after drug withdrawal,ACT and APTT of both groups decreased significantly and the decreasing degree of the bivalirudin group was higher(P<0.05).The incidence of bleeding events of observation group was statistically significant lower(4.35%,1/23)than that of control group(17.39%,4/23)(P<0.05).Conclusions Bivalirudin has comparable anticoagulation effect as heparin during carotid artery stenting with lower bleeding incidence,lower side-effect,shorter half-life and higher security.

关 键 词：比伐芦定 颈动脉狭窄 支架置入术 安全性 

分 类 号：R543.5[医药卫生—心血管疾病]