比伐芦定与普通肝素在老年冠心病患者择期冠状动脉介入治疗术中的应用  

Application of bivalrudine and unfractionated heparin in elderly patients with coronary heart disease undergoing elective percutaneous coronary intervention

作　　者：刘文民[1] 王明伟[1] 郑勇 闫希贵 彭怀明 杨德业 Liu Wenmin;Wang Mingwei;Zheng Yong;Yan Xigui;Peng Huaiming;Yang Deye(Department of Cardiology,the Affiliated Hospital of Hangzhou Normal University,Hangzhou 310015,China;Department of Respiratory,People's Hospital of Tinghu District,Yancheng 224001,China)

机构地区：[1]杭州师范大学附属医院心内科,杭州310019 [2]亭湖区人民医院呼吸科,盐城224001

出　　处：《心脑血管病防治》2022年第5期59-62,共4页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

基　　金：浙江省自然科学基金项目(LZ16H020003);杭州市科技发展计划项目(20191203B96)。

摘　　要：目的比较比伐芦定与普通肝素在老年冠心病患者择期冠状动脉介入(PCI)治疗中的有效性和安全性。方法选取2018年5月至2020年12月在亭湖区人民医院行择期PCI治疗的老年冠心病患者100例,随机分为比伐芦定和普通肝素组各50例,分别予以术中抗凝。患者术后均随访30 d,主要研究终点为术后30 d内主要心血管不良事件(MACE),包括心源性死亡、心肌梗死再发、靶血管血运重建,次要终点为术后30 d内出血情况、支架内血栓形成及术前术后血检指标变化。结果两组间MACE事件发生率、出血情况(轻度、严重)、支架内血栓形成及术前术后血检指标(血红蛋白、红细胞压积、血小板计数)比较,差异均无统计学意义(t/χ^(2)=0.154、0.122、2.041、0.344、0.340、1.081、-1.073、-1.153、1.478、0.719,P>0.05)。结论老年患者择期PCI术中应用比伐芦定与普通肝素相比,术后30 d内的MACE及出血等方面并无显著降低。Objective To evaluate the effectiveness and safety of bivalirudin versus unfractionated heparin in elderly patients with coronary heart disease(CHD)who were performed selective percutaneous coronary intervention(PCI).Methods From May 2018 to December 2020,100 elderly patients with CHD,who were admitted in People's Hospital of Tinghu District and were performed selective PCI,were enrolled.They were randomly divided into two groups,each had 50 cases.During the procedure,the patients in the two groups were used bivalirudin or ordinary unfractionated heparin respectively.They were all followed up for 30 days after operation.The primary outcome was MACE events including cardiac death,reinfarction,and target vascular reconstruction within 30 days after operation.The secondary endpoints were bleeding at 30 days after operation,intrastent thrombosis and changes in blood test indicators before and after surgery.Results There were no significant differences in the incidence of MACE events,bleeding(mild and severe),intra-stent thrombosis,and preoperative and postoperative blood test indicators(hemoglobin,hematocrit,platelet)between the two groups(t/χ^(2)=0.154,0.122,2.041,0.344,0.340,1.081,-1.073,-1.153,1.478,0.719;P>0.05).Conclusion Compared with unfractionated heparin,the application of bivalrudine during elective PCI in elderly patients doesn't significantly reduce the MACE events and bleeding within 30 days.

关 键 词：比伐芦定 普通肝素 冠状动脉介入治疗 抗凝 

分 类 号：R541.4[医药卫生—心血管疾病]