比伐卢定对行PCI治疗高危ACS患者的抗凝效果及对犯罪血管的影响分析  

Analysis of the anticoagulant effect of Bivalirudin on high-risk ACS patients treated with PCI and its influence on the blood vessels of criminals

作　　者：程军[1] 魏婕[1] 方洁[1] 王丽华[1] 徐信 马超 朱永新[1] 方中[1] 徐晓东[1] CHENG Jun;WEI Jie;FANG Jie(Department of Cardiovascular Medicine,Chizhou People's Hospital,Chizhou Anhui 247000,China)

机构地区：[1]池州市人民医院心血管内科,安徽池州247000

出　　处：《临床和实验医学杂志》2020年第18期1952-1955,共4页Journal of Clinical and Experimental Medicine

基　　金：安徽省科技攻关项目(编号:1701041142)。

摘　　要：目的探究比伐卢定在高危急性冠脉综合征(ACS)患者PCI术中的疗效,评价其抗凝效果及对犯罪血管心肌梗死溶栓治疗(TIMI)TIMI血流分级的影响。方法采用前瞻性研究方法,选取2016年11月至2018年11月池州市人民医院收治的120例行PIC术的ACS患者,按照随机数字表法将其分为两组:对照组和观察组,每组各60例。对照组患者予以肝素+替罗非班治疗,观察组患者予以比伐卢定治疗。观察并比较两组患者的心脏不良事件发生情况、出血情况、凝血效果以及血管TIMI血流分级。结果住院及术后随访期间,两组患者无复流、血小板减少症及不良心血管事件发生率比较,差异均无统计学意义(P>0.05);观察组均为轻度牙龈出血,无严重出血,其总出血率为1.67%,明显低于对照组的11.67%,差异具有统计学意义(P<0.05)。用药后,观察组患者的活化部分凝血酶时间(APTT)(61.24±8.86)s、凝血酶原时间(PT)(21.88±3.13)s、凝血酶时间(TT)(22.17±3.16)s均显著高于对照组的(45.77±6.52)s、PT(16.73±2.35)s、TT(15.35±2.18)s,且观察组纤维蛋白原(FIB)(1.84±0.25)g/L显著低于对照组(2.62±0.37)g/L,差异均有统计学意义(P<0.05);两组患者PCI术后冠状动脉犯罪血管TIMI血流分级比较,差异无统计学意义(P>0.05)。结论高危ACS患者PCI术中应用比伐卢定可有效发挥抗凝作用,降低术后出血事件发生率,值得推广应用。Objective To explore the efficacy of Bivaludine in PCI in high-risk ACS patients,and to evaluate its anticoagulant effect and its influence on TIMI blood flow classification in criminal vessels.Methods In this prospective study,120 ACS patients admitted to Chizhou People's Hospital from November 2016 to November 2018 were selected and divided into two groups according to the random number table method:control group and observation group,with 60 patients in each group.The control group was treated with Heparin+Tirofiban,while the observation group was treated with Bivarudine.To observe and compare the incidence of adverse cardiac events,bleeding,coagulation effect and TIMI blood flow grading between the two groups.Results During hospitalization and postoperative follow-up,there was no significant difference in the incidence of reflow,thrombocytopenia or adverse cardiovascular events between the two groups(P>0.05).The total bleeding rate in the observation group was 1.67%,significantly lower than that in the control group 11.67%(P<0.05).After treatment,APTT(61.24±8.86)s,PT(21.88±3.13)s,TT(22.17±3.16)s of the observation group were significantly higher than those of the control group(45.77±6.52)s,PT(16.73±2.35)s,TT(15.35±2.18)s,and FIB(1.84±0.25)g/L of the observation group was significantly lower than that of the control group(2.62±0.37)g/L,with statistically significant difference(P<0.05).Comparison of TIMI blood flow grading between the two groups after PCI showed no statistically significant difference(P>0.05).Conclusion The application of bivarudine in PCI of high-risk ACS patients can effectively exert anticoagulant effect and reduce the incidence of postoperative bleeding events,which is worthy of promotion.

关 键 词：急性冠脉综合征 经皮冠状动脉介入治疗 比伐卢定 抗凝 

分 类 号：R541.4[医药卫生—心血管疾病]