急性冠状动脉综合征合并高出血风险患者PCI术中应用比伐卢定疗效观察  

Therapeutic effect of bivalirudin during PCI in patients with acute coronary syndrome complicated with high bleeding risk

作　　者：杨蕾[1] 东洋[1] YANG Lei;DONG Yang(Department of Cardiovascular Medicine,Second Affiliated Hospital of Shenyang Medical College,Shenyang,Liaoning 110002,China)

机构地区：[1]沈阳医学院附属第二医院心血管内科

出　　处：《中国动脉硬化杂志》2019年第11期960-964,共5页Chinese Journal of Arteriosclerosis

基　　金：沈阳医学院科技基金项目(20172031)

摘　　要：目的探讨急性冠状动脉综合征合并高出血风险患者行经皮冠状动脉介入治疗(PCI)术中应用比伐卢定的治疗效果及安全性。方法选取108例急性冠状动脉综合征合并高出血风险并且接受PCI治疗的患者,将患者随机平均分为试验组(比伐卢定组)和对照组(普通肝素组),每组54例。比较试验组和对照组术前术后的TIMI血流、活化凝血时间(ACT)达标率、血小板计数、血小板聚集率、高敏C反应蛋白(hs-CRP)和白细胞介素4(IL-4)、30天出血事件及主要不良心血管事件(MACE)发生率。结果试验组与对照组比较,TIMI血流无明显差异。试验组ACT达标率、血小板计数、血小板聚集率、hs-CRP、IL-4等指标均明显优于对照组,差异有统计学意义(P<0.05)。试验组出血事件发生率及MACE发生率显著低于对照组,差异有统计学意义(P<0.05)。结论急性冠状动脉综合征合并高出血风险患者PCI术中应用比伐卢定,可明显降低出血事件及MACE的发生率,且具有良好的安全性。Aim To investigate the efficacy and safety of bivalirudin during percutaneous coronary intervention(PCI)for patients with acute coronary syndrome and high bleeding risk.Methods 108 patients with acute coronary syndrome and high bleeding risk and receiving PCI treatment were randomly divided into test group(bivalirudin group)and control group(heparin group),54 cases in each group.TIMI blood flow,activated coagulation time(ACT),platelet count,platelet aggregation rate,high-sensitivity C-reactive protein(hs-CRP)and interleukin-4(IL-4),30-days bleeding events and major adverse cardiovascular events(MACE)were compared between the test group and the control group before and after operation.Results There was no significant difference in TIMI blood flow between the test group and the control group.The ACT compliance rate,platelet count,platelet aggregation rate,hs-CRP,IL-4 and other indicators in the test group were significantly better than those in the control group,and the differences were statistically significant(P<0.05).The incidences of hemorrhagic events and MACE in the test group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion The application of bivalirudin during PCI for patients with acute coronary syndrome and high bleeding risk can significantly reduce the incidences of bleeding events and MACE,and has good safety.

关 键 词：比伐卢定 急性冠状动脉综合征 高出血风险 经皮冠状动脉介入治疗 血小板聚集率 主要不良心血管事件 

分 类 号：R54[医药卫生—心血管疾病]