脑卒中合并冠心病患者PCI中应用不同剂量比伐卢定对PLT、MPV及FIB的影响  

Effects of different doses of bivalirudin on PLT,MPV and FIB in patients with stroke complicated with coronary heart disease during PCI

作　　者：邓俊国[1] 孟令秀 熊爱红 王雪梅[2] 王龙[3] DENG Junguo;MENG Lingxiu;XIONG Aihong;WANG Xuemei;WANG Long(Department of Cardiology,the Second Hospital of Qinhuangdao,Qinhuangdao,Hebei,China,066600;Department of Infectious Diseases,the Second Hospital of Qinhuangdao,Qinhuangdao,Hebei,China,066600;Department of Cardiac Electrophysiology,Peking University People's Hospital,Beijing,China,100044)

机构地区：[1]秦皇岛市第二医院心内一科,河北秦皇岛066600 [2]秦皇岛市第二医院感染科,河北秦皇岛066600 [3]北京大学人民医院心电生理室,北京100044

出　　处：《分子诊断与治疗杂志》2022年第8期1346-1349,共4页Journal of Molecular Diagnostics and Therapy

基　　金：秦皇岛市重点研发计划科技支撑项目(201805A018)。

摘　　要：目的分析脑卒中合并冠心病患者经皮冠状动脉介入治疗(PCI)中应用不同剂量比伐卢定对血小板计数(PLT)、平均血小板体积(MPV)、纤维蛋白原(FIB)的影响。方法选取2019年1月至2021年4月秦皇岛市第二医院收治的153例脑卒中合并冠心病患者,均行PCI手术治疗,根据术中使用比伐卢定剂量不同分为低剂量组68例[术中1.5 mg/(kg·h)术后0.15 mg/(kg·h)]与全剂量组85例[术中1.75mg/(kg·h)术后0.2 mg/(kg·h)]。比较两组治疗后24 h PLT、MPV、FIB水平变化;比较两组治疗后30 d心功能情况;比较两组治疗后30 d出血事件及治疗后6个月不良心脑血管事件(MACCE)发生情况。结果治疗前两组PLT、MPV、FIB水平比较差异无统计学意义(P>0.05),治疗后24 h两组PLT、FIB、MPV明显降低,且全剂量组明显低于低剂量组,差异均有统计学意义(P<0.05)。治疗前两组LVEF、E/A比较差异无统计学意义(P>0.05),治疗后30 d两组LVEF、E/A值均升高,且全剂量组明显高于低剂量组,差异均有统计学意义(P<0.05)。低剂量组30 d内出血事件总发生率为2.94%,全剂量组总发生率为4.71%,两组比较差异无统计学意义(P>0.05)。低剂量组6个月MACCE总发生率为7.35%,全剂量组总发生率为3.53%,两组比较差异无统计学意义(P>0.05)。结论脑卒中合并冠心病患者PCI中使用比伐卢定可明显改善患者凝血状态,降低PLT、FIB、MPV表达水平,使用全剂量比伐卢定可获得更为理想的治疗效果,安全性尚可。Objective To analyze the effect of different doses of bivalirudin on platelet count(PLT),mean platelet volume(MPV)and Fibrinogen(FIB)in patients with stroke complicated with coronary heart disease during percutaneous coronary intervention(PCI).Methods 153 stroke patients with coronary heart disease admitted to Qinhuangdao Second Hospital from January 2019 to April 2021 were selected for PCI surgery,according to the intraoperative dose of bivalirudin,68 patients were divided into a low-dose group[Surgery In the middle 1.5 mg/(kg·h)postoperative 0.15 mg/(kg·h)]and the full dose group of 85 cases[intraoperative 1.75 mg/(kg·h)postoperative 0.2 mg/(kg·h)].The changes of PLT,MPV and FIB levels at 24 h after treatment between the two groups were compared;the cardiac function at 30 days after treatment was compared between the two groups.The bleeding events at 30 days after treatment and the occurrence of adverse cardiovascular and cerebrovascular events(MACCE)at 6 months after treatment were compared between the two groups.Results There was no significant difference in the levels of PLT,MPV and FIB between the two groups before treatment(P>0.05),and the levels of PLT,FIB and MPV in the two groups were significantly decreased at 24 h after treatment,and the full-dose group was significantly lower than the low-dose group,and the difference was statistically significant(P<0.05).There was no significant difference in LVEF and E/A between the two groups before treatment(P>0.05),but the value of LVEF and E/A in the two groups 30 d after treatment were increased,and the values in the full-dose group were significantly higher than those in the low-dose group,and the difference was statistically significant(P<0.05).The total incidence of bleeding within 30 days in the low-dose group was 2.94%,and the full-dose group was 4.71%,there was no difference between the two groups(P>0.05).The total incidence of MACCE at 6 months in the low-dose group was 7.35%,and the full-dose group was 3.53%,there was no difference between the two

关 键 词：脑卒中合并冠心病 PCI 比伐卢定 PLT MPV FIB 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R541.4[医药卫生—临床医学]