比伐芦定与肝素用于ST段抬高型急性心肌梗死患者PCI围术期抗凝的效果比较  

Comparison of effects of Bivalirudin and Heparin on perioperative anticoagulation in patients with ST-segment elevation acute myocardial infarction undergoing PCI

作　　者：杨玉强 YANG Yuqiang(Emergency Department of Xichuan County Second People’s Hospital,Nanyang 474450 Henan,China)

机构地区：[1]淅川县第二人民医院急诊科,河南南阳474450

出　　处：《中国民康医学》2024年第11期119-121,共3页Medical Journal of Chinese People’s Health

摘　　要：目的:比较比伐芦定与肝素用于ST段抬高型急性心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)围术期抗凝的效果。方法:选取2020年3月至2023年3月该院收治的102例行PCI术的STEMI患者进行前瞻性研究,按照随机数字表法分为研究组与对照组各51例。对照组PCI围术期采用肝素钠注射液抗凝,研究组PCI围术期采用注射用比伐芦定抗凝,比较两组炎性因子[血清白细胞介素(IL)-4、IL-8、超敏C反应蛋白(hs-CRP)]水平、血清指标[生长分化因子15(GDF-15)、脑钠肽(BNP)、肌钙蛋白I(cTnI)]水平和术后6个月心脑血管不良事件发生率。结果:出院时,两组血清IL-4、IL-8、hs-CRP、GDF-15、BNP、cTnI水平低于术前,且研究组低于对照组,差异均有统计学意义(P<0.05);术后6个月,研究组心脑血管不良事件发生率为3.92%,明显低于对照组的15.69%,差异有统计学意义(P<0.05)。结论:比伐芦定用于STEMI患者PCI围术期抗凝可降低其血清炎性因子、GDF-15、BNP、cTnI水平以及心脑血管不良事件发生率,效果优于肝素治疗。Objective:To compare effects of Bivalirudin and Heparin on perioperative anticoagulation in patients with ST-segment elevation acute myocardial infarction(STEMI)undergoing percutaneous coronary intervention(PCI).Methods:A prospective study was conducted on 102 STEMI patients who underwent PCI in this hospital from March 2020 to March 2023.According to the random number table method,they were divided into study group and control group,51 cases in each group.The control group was treated with Heparin sodium injection for anticoagulation during the perioperative period of PCI,while the study group was treated with Bivalirudin for injection.The levels of inflammatory factors[serum interleukin(IL)-4,IL-8,high-sensitivity C-reactive protein(hs-CRP)],serological indexes[growth differentiation factor-15(GDF-15),brain natriuretic peptide(BNP),cardiac troponin I(cTnI)],and the incidence of cardiovascular and cerebrovascular adverse events 6 months after the surgery were compared between the two groups.Results:At discharge,the levels of serum IL-4,IL-8,hs-CRP,GDF-15,BNP and cTnI in the two groups were lower than those before the surgery,those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).Six months after the surgery,the incidence of cardiovascular and cerebrovascular adverse events in the study group was 3.92%,which was significantly lower than 15.69%in the control group,and the difference was statistically significant(P<0.05).Conclusions:Bivalirudin for perioperative anticoagulation in the STEMI patients undergoing PCI can reduce the levels of serum inflammatory factors,GDF-15,BNP,cTnI and the incidence of cardiovascular and cerebrovascular adverse events.Moreover,it is superior Heparin treatment.

关 键 词：ST段抬高型急性心肌梗死 冠状动脉介入 比伐芦定 肝素 炎性因子 血清学 心脑血管不良事件 

分 类 号：R541.4[医药卫生—心血管疾病]