小分子直接凝血酶抑制剂阿加曲班在急性冠脉综合征中的应用

Clinical Anylysis of Using Micromolecule Direct Thrombin Inhibitor Argatroban in Treatment of Acute Coronary Syndrome

目的:观察小分子直接凝血酶抑制剂阿加曲班在急性冠脉综合征疗效及副作用方法:将64例急性冠脉综合征患者随机分为阿加曲班治疗组(A组)和普通肝素治疗组(H组)。阿加曲班治疗组给予生理盐水加阿加曲班20mg静脉滴注,普通肝素治疗组给予生理盐水加普通肝素100mg静脉滴注,分别比较两组患者治疗前和治疗后2小时、4小时、12小时、24小时、48小时的血小板计数、部分凝血酶活动时间变化情况并观察两组病例疼痛、心梗发生情况及出血等不良反应发生情况。结果:阿加曲班治疗组和普通肝素治疗组治疗前和治疗后2小时4小时、12小时、24小时、48小时部分凝血酶活动时间出现不同程度变化,对疼痛改善、心梗发生情况两组比较无差异。阿加曲班治疗组对血小板影响小,有少量不良反应,普通肝素治疗组对血小板有一定影响,存在出血等不良反应。结论:小分子直接凝血酶抑制剂阿加曲班在急性冠脉综合征中应用安全有效,尤其适用于肝素诱发的血小板减少患者和不能对凝血功能严格监测患者。

Objective： To observe the therapy and side effect of micromolecule direct thrombin inhibitor argatroban in treatment of patients with acute coronary syndrome（ACS）.Methods： Sixty-four patients with ACS were randomly divided into 2 groups：argatroban group （A group） and heparin group （H group）.Patients in A group were treated with argatroban 20mg,and H group were treated with heparin 100mg.PLT and APTT were measured before or after the administration.The improvement of chest pain,the incidence of AMI,and the adverse reaction as bleeding between two groups should also be compared.Results： APTT,the improvement of ache,and the incidence of AMI had no difference between two groups.A group and H group all had adverse reaction as bleeding.H group had affected PLT,the different with A group.Conclusion： Micromolecule direct thrombin inhibitor argatroban could be used in the treatment of patients with acute coronary syndrome,especially in patients with heparin induced thrombocytopenia,and patients short of thromboxane monitoring,and it was safety and effective.