比伐芦定对高危出血风险冠心病行冠状动脉介入治疗患者的临床应用效果  

Effect of Bivalirudin in Patients with Coronary Heart Disease of High Bleeding Risk Undergoing Percutaneous Coronary Intervention

作　　者：郭继东[1] 魏华 赵媛媛[1] 王磊 刘丹[1] 韩艺辉[1] 奴尔巴哈提 GUO Ji-dong;WEI Hua;ZHAO Yuan-yuan(Department of Cardiovascular Medicine,Shihezi People′s Hospital,Shihezi 832000,China)

机构地区：[1]石河子市人民医院心血管内科,新疆石河子832000

出　　处：《吉林医学》2023年第11期3114-3117,共4页Jilin Medical Journal

基　　金：石河子市重点领域科技攻关计划项目[项目编号:2022SF010];兵团科技计划项目中青年领军人才[项目编号:2020CB012];石河子市人民医院科技计划项目[项目编号:2020LC07、2020LC01]。

摘　　要：目的:研究比伐芦定对高危出血风险冠心病行冠状动脉介入(PCI)治疗患者的临床应用效果。方法:选取行介入治疗冠心病出血高危人群的患者60例作为研究对象,随机分为试验组和对照组各30例,两组患者均接受PCI手术治疗,对照组患者PCI接受常规剂量比伐芦定治疗,试验组则接受低剂量比伐芦定治疗,并对患者出院后展开30 d随访。比较两组患者PCI成功率以及术中活化凝血酶时间(ACT);比较两组手术前后凝血功能[凝血酶时间(TT)、血浆凝血酶原时间(PT)];比较两组随访期间出现的不良心血管事件发生率以及支架内血栓和血小板减少症发生情况。结果:与对照组比较,试验组术中活化凝血酶时间显著更短,差异有统计学意义(P<0.05);治疗后,两组患者TT均显著高于治疗前,PT均显著低于治疗前,差异有统计学意义(P<0.05);试验组不良心血管事件发生率与对照组比较,差异无统计学意义(P>0.05);试验组出血事件发生率显著低于对照组,差异有统计学意义(P<0.05)。结论:低剂量与常规剂量比伐芦定对于高危出血风险冠心病行PCI治疗患者的效果相当,安全性较高且不会增加不良反应,还可以降低再出血的发生率。Objective To analyze the effect of bivalirudin in patients with coronary heart disease of high bleeding risk undergoing percutaneous coronary intervention(PCI).Method Sixty patients with coronary heart disease of high bleeding risk underwent PCI in our hospital were enrolled,and randomly divided into control group and experimental group,with 30 cases in each group.Both groups of patients received PCI surgery treatment.During the PCI,control group received conventional-dose bivalirudin treatment,while experimental group received low-dose bivalirudin treatment.A 30-day follow-up was carried out after discharge.PCI success rate,intraoperative activated coagulation time(ACT),coagulation function parameters[thrombin time(TT),plasma prothrombin time(PT)],and the incidence rate of major adverse cardiovascular events,stent thrombosis and thrombocytopenia were compared between two groups during follow-up.Results The intraoperative ACT of control group was significantly longer than that of experimental group(P<0.05).An increase in TT and a decrease in PT were found in both groups after treatment(all P<0.05).The incidence rate of major adverse cardiovascular events in experimental group and control group was compared,with no statistical difference(P>0.05).The incidence rate of bleeding events in experimental group was significantly lower than control group,with statistical difference(P<0.05).Conclusion Compared with conventional dose,application of low-dose bivalirudin in patients with coronary heart disease at high bleeding risk undergoing PCI achieves same clinical efficacy and high safety,and can reduce the occurrence of rebleeding without increasing occurrence rate of adverse reactions.

关 键 词：比伐芦定 高危出血风险 冠心病 冠状动脉介入 安全性 

分 类 号：R541.4[医药卫生—心血管疾病]