比伐卢定单用或联用替罗非班与肝素联用替罗非班在老年急性心梗患者介入治疗中的疗效比较  

Bivalirudin or bivalirudin combined with tirofiban versus heparin combined with tirofiban in interventional therapy for elderly patients with acute myocardial infarction

作　　者：杨晓丽[1] 王全政 张华梅[1] 郭方圆[1] 张龙飞 王顺吉[1] Yang Xiaoli;Wang Quanzheng;Zhang Huamei;Guo Fangyuan;Zhang Longfei;Wang Shunji(Second Department of Cardiology,Shouguang People's Hospital,Shouguang 262700,China)

机构地区：[1]寿光市人民医院心血管内二科,262700

出　　处：《国际医药卫生导报》2020年第18期2740-2743,共4页International Medicine and Health Guidance News

摘　　要：目的评价比伐卢定单用或联用替罗非班与肝素联用替罗非班在老年急性心肌梗死患者介入治疗中的有效性和安全性。方法回顾性分析2017年12月至2019年12月于本院行急诊PCI的老年急性心肌梗死患者155例(年龄范围为65~75岁)的临床资料,其中比伐卢定单用或比伐卢定联用替罗非班组68例,肝素联用替罗非班组87例;比较两组患者住院期间主要不良心血管事件(main adverse cardiovascular events,MACE)、出血事件的发生率。结果两组患者住院期间总MACE事件发生率、心源性猝死、支架内血栓形成、急性心衰发生率比较,差异均无统计学意义(均P>0.05);比伐卢定组住院期间总出血风险、主要出血风险、小出血风险率分别为8.8%、2.9%、5.9%,均低于肝素+替罗非班组28.7%、11.5%、17.2%,差异均有统计学意义(均P<0.05)。结论比伐卢定在老年急性心肌梗死患者急诊PCI治疗中安全有效,与应用肝素+替罗非班相比,主要临床获益为降低出血风险。Objectives To evaluate the efficacies and safety of bivalirudin or bivalirudin combined with tirofiban versus heparin combined with tirofiban in interventional therapy for elderly patients with acute myocardial infarction.Methods The clinical data of 155 elderly patients with acute myocardial infarction who were 65 and 75 years old and underwent emergency PCI at our hospital during from December,2017 to December,2019 were retrospectively analyzed.Among which,68 cases were treated with bivalirudin alone or combined with tirofiban,and the other 87 cases were treated with heparin and tirofiban.to compare The incidences of main adverse cardiovascular events(MACE)and bleeding events during hospitalization between the two groups.Results There were no statistical differences in the incidences of MACE,sudden cardiac death,stent thrombosis,and acute heart failure between the two groups(all P>0.05).The total,main,and minor bleeding risks were significantly lower in the bivalirudin group than in the heparin and tirofiban group[8.8%vs.28.7%,2.9%vs.11.5%,and 5.9%vs.17.2%;all P<0.05].Conclusions Bivalirudin is safe and effective in emergency PCI treatment for elderly patients with acute myocardial infarction,with lower bleeding risks compared with the treatment of heparin combined with tirofiban.

关 键 词：比伐卢定 替罗非班 急性心肌梗死 肝素 

分 类 号：R542.22[医药卫生—心血管疾病]