PCI术前预防性应用比伐卢定与肝素的抗凝效果对比  

Study on the significance of preventive application of bivalirudine and heparin before PCI

作　　者：马元凤 刘佰学 马德渊 MA Yuan-feng;LIU Bai-xue;MA De-yuan(Department of Heart Failure,Qinghai Province Ccardiovascular and Cerebrovascular Specialist Hospital,Xining Qinghai 810008,China;Department of Cardiovascular Medicine,the First Affiliated Hospital of Xi'an Medical University,Xi'an Shannxi 710077,China;Department of Emergency Surgery,Qinghai Xining First People's Hospital,Xining Qinghai 810000,China)

机构地区：[1]青海省心脑血管病专科医院心力衰竭科,青海西宁810008 [2]西安医学院第一附属医院心血管内科,陕西西安710077 [3]西宁市第一人民医院急诊外科,青海西宁810000

出　　处：《临床和实验医学杂志》2019年第23期2575-2576,F0003,共3页Journal of Clinical and Experimental Medicine

基　　金：青海省自然科学基金项目(编号:2016010312)

摘　　要：目的对比观察经皮冠状动脉介入(PCI)术前应用比伐卢定与肝素的抗凝效果。方法采用前瞻性研究方法,选取2017年1月至2018年6月青海省心脑血管病专科医院和西安医学院第一附属医院收治的120例行PCI术的冠心病患者作为研究对象,按照随机平行分组法随机分为研究组(n=60)与对照组(n=60),对照组患者给予肝素治疗,研究组患者给予比伐卢定治疗,对比两组患者停药2 h后活化凝血时间(ACT)、活化凝血酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)和纤维蛋白原(FIB)、出血率、心血管不良事件发生率。结果研究组患者的ACT(206.32±29.43 s)明显低于对照组(239.15±30.14 s)(P<0.05);研究组患者的APTT(29.34±4.25 s)、TT(29.04±7.93 s)、PT(11.53±0.25 s)、FIB(2.53±0.57 g/L)与对照组(31.04±5.85 s、32.85±9.21 s、12.04±0.42 s、2.48±0.59 g/L)相比,差异无统计学意义(P>0.05)。研究组患者的出血率(3.33%)、心血管不良事件发生率(0)明显低于对照组(13.33%、8.33%)(P<0.05)。结论与肝素治疗相比,PCI术前应用比伐卢定抗凝治疗能够有效缩短凝血时间,降低不良事件发生率,安全性高,有利于患者预后,具有显著临床优势。Objective To compare the anticoagulant effect of bivalirudine and heparin before PCI.Methods A prospective study was conducted in selection of 120 patients with coronary heart disease underwent PCI in Qinghai Special Hospital of Cardiovascular and Cerebrovascular Diseases and the First Affiliated Hospital of Xi'an Medical College during January 2017 to June 2018.These patients were randomly divided into study group and control group,patients in study group were given with bivalirudin,and these two groups were analyzed for activated group according to the random parallel grouping method(n=60).Patients in control group(n=60)were examined with clotting time(ACT)and activated thrombin time(APTT)after 2 h of withdrawal,prothrombin time(PT),thrombin time(TT)and blood level of fibrinogen(FIB),bleeding rate,incidence of cardiovascular adverse events.Results The ACT(206.32±29.43s)of study group was significantly lower than that of control group(239.15±30.14 s)(P<0.05).The APTT(29.34±4.25 s),TT(29.04±7.93 s),PT(PTT)in study group(11.53±0.25 s),FIB(2.53±0.57 g/L)and control group(31.04±5.85 s,32.85±9.21 s,12.04±0.42 s,2.48±0.59 g/L),but the difference was not statistically significant(P>0.05).The bleeding rate(3.33%)and the incidence of cardiovascular adverse events(0%)in study group were significantly lower than those of control group(13.33%,8.33%)(P<0.05).Conclusion In comparison with heparin therapy,bivalirudin anticoagulation therapy before PCI can effectively shorten the coagulation time,reduce the incidence of adverse events,with high safety,and benefit the prognosis of patients,hence it has significant clinical advantages.

关 键 词：经皮冠状动脉介入治疗术 比伐卢定 肝素 抗凝 对比研究 

分 类 号：R54[医药卫生—心血管疾病]