比伐芦定对行经皮冠状动脉介入治疗急性冠状动脉综合征患者冠状动脉微循环的影响及短期预后评价  

The effect of bivalirudin on coronary microcirculation and short-term prognosis evaluation in acute coronary syndrome patients undergoing percutaneous coronary intervention

作　　者：王盼盼 穆耶塞尔·阿卜拉 李秀芬[1] WANG Pan-pan;Muyesaier·Abula;LI Xiu-fen(Department of Cardiology,Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University,Urumqi 830000,China)

机构地区：[1]新疆医科大学附属中医医院心内科,新疆乌鲁木齐830000

出　　处：《中国介入心脏病学杂志》2023年第12期915-920,共6页Chinese Journal of Interventional Cardiology

基　　金：新疆维吾尔自治区自然科学基金项目(2022D01C165)。

摘　　要：目的比较经皮冠状动脉介入治疗(PCI)中应用比伐芦定与普通肝素对急性冠状动脉综合征(ACS)患者冠状动脉微循环的影响及预后。方法回顾性分析2020年1月至2023年3月在新疆医科大学附属中医医院急诊或住院接受PCI的312例ACS患者,分析一般临床资料,根据患者围术期的不同抗凝方案,分为比伐芦定组153例,普通肝素组159例,观察比较两组术后心肌梗死溶栓治疗试验(TIMI)血流分级、TIMI心肌灌注分级(TMPG)、心电图ST段回落率(STR)、心绞痛发作次数、术后7 d内不良事件发生率、术后3个月内主要不良心血管事件(MACE)发生率和出血事件发生率。结果两组患者的一般临床资料及介入术中情况比较,差异均无统计学意义(均P>0.05)。两组患者PCI术后TIMI血流分级差异无统计学意义(P=0.959),但PCI术后TMPG、心绞痛发作次数、心电图STR比较,差异均有统计学意义(均P<0.05)。两组患者PCI术后7 d内不良事件发生率、PCI术后3个月内MACE的总发生率、PCI术后3个月内出血事件发生率比较,差异均无统计学意义(均P>0.05)。结论比伐芦定用于PCI安全有效,可改善冠状动脉微循环,且不增加MACE、出血事件及支架内血栓事件发生率。Objective To compare the effects and prognosis between bivalirudin and heparin on coronary microcirculation in patients with acute coronary syndrome(ACS)during percutaneous coronary intervention(PCI).Methods A retrospective analysis was conducted on 312 ACS patients who underwent PCI treatment in the Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University from January 2020 to March 2023.General clinical data were analyzed and divided into a bivalvrudin group of 153 patients and a heparin group of 159 patients based on different anticoagulation regimens during the perioperative period.The postoperative thrombolysis in myocardial infarction(TIMI)blood flow grading,TIMI myocardial perf usion grading(TMPG),ST segment regression rate(STR)of electrocardiogram,and the number of angina pectoris episodes were observed and compared between the two groups The incidence of adverse events within 7 days after surgery,the incidence of major adverse cardiovascular events(MACE)within 3 months after surgery,and the incidence of bleeding events.Results There was no statistically significant difference in the general clinical data and intraoperative conditions between the two groups of patients(both P>0.05).There was no statistically significant difference in TIMI blood flow grading between the two groups of patients after PCI(P=0.959).The TMPG grading of two groups of patients after PCI was statistically significant(P=0.001).The number of angina attacks and ST segment regression rate of electrocardiogram in both groups of patients after PCI were statistically significant(both P<0.05).The incidence of adverse events within 7 days after PCI in two groups of patients was not statistically significant(P=0.285).There was no statistically significant difference in the total incidence of MACE events within 3 months after PCI between the two groups of patients(P=0.195).There was no statistically significant difference in the incidence of bleeding events within 3 months after PCI between the two groups of patients(al

关 键 词：比伐芦定 普通肝素 急性冠状动脉综合征 经皮冠状动脉介入治疗 冠状动脉微循环 

分 类 号：R541.4[医药卫生—心血管疾病]