比伐芦定抗凝治疗在冠状动脉钙化病变旋磨术中安全性与有效性的研究  

Safety and Efficacy of Bivalirudin in Coronary Rotational Atherectomy for Calcified Coronary Lesions

作　　者：张涛[1] 段作成 冯婷婷[1] 张宇晨[1] 王志坚[1] 赵林[1] ZHANG Tao;DUAN Duocheng;FENG Tingting;ZHANG Yuchen;WANG Zhijian;ZHAO Lin(Department of Cardiology,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所心内科,100029 [2]山东省邹平市中医院心病科

出　　处：《心肺血管病杂志》2024年第2期123-128,共6页Journal of Cardiovascular and Pulmonary Diseases

基　　金：北京市医管局培育基金(PZ2021008);首都卫生发展科研基金(2022-2-1052);国家自然科学基金(81670391)。

摘　　要：目的:评价比伐芦定在冠状动脉钙化病变旋磨治疗中的有效性和安全性。方法:连续入选北京安贞医院2019年1月至2021年12月,因冠状动脉重度钙化病变行旋磨术入院的患者182例,其中88例使用比伐芦定抗凝治疗,94例使用普通肝素抗凝治疗。分析患者的临床基本资料、病变特点、旋磨治疗情况、并发症及住院期间主要不良心脑血管事件。结果:普通肝素组1例患者旋磨未成功,其余所有患者均旋磨成功并置入支架。比伐芦定组患者围术期心肌损伤显著少于普通肝素组(8.0%vs.18.1%,P=0.044),比伐芦定组患者总出血事件显著少于普通肝素组(4.5%vs. 14.9%,P=0.025),住院期间无主要心血管不良事件发生。结论:旋磨术中使用比伐芦定抗凝治疗能显著减少围术期心肌损伤和出血事件的发生率。Objective:To explore the safety and efficiency of bivalirudin in rotational atherectomy for calcified coronary lesions.Methods:From January 2019 to December 2021,182 patients(88 cases in bivalirudin group vs.94 cases in unfractionated heparin group)with severe coronary calcification lesions who underwent rotational atherectomy were enrolled in our study.Clinical data,angiographic characteristics and rotational atherectomy details were analyzed.Complications and major adverse cardiovascular events(MACE)were also documented.Results:Except for one patient in unfractionated heparin group who failed,all other patients successfully underwent Rotational atherectomy and stents were implanted.The perioperative myocardial injury(8.0%vs.18.1%,P=0.044)and total bleeding events(4.5%vs.14.9%,P=0.025)in bivalirudin group was significantly less than that in unfractionated heparin group.No MACE occurred during hospitalization.Conclusions:The use of bivalirudin in rotational atherectomy for calcified coronary lesions could significantly reduce perioperative myocardial injury and the incidence of bleeding events.

关 键 词：冠状动脉钙化病变 冠状动脉旋磨术 抗凝治疗 比伐芦定 

分 类 号：R54[医药卫生—心血管疾病]