国产注射用比伐卢定和肝素在冠状动脉介入术中对凝血功能的影响

Effects of heparin and domestic bivalirudin on coagulation during percutaneous coronary intervention

目的:探讨国产注射用比伐卢定和肝素在冠状动脉介入术中对凝血功能的影响。方法:选择60例择期行PCI的患者,术中分别采用肝素(n=30)或国产注射用比伐卢定(n=30)抗凝。分别在用药前、用药后10 min、用药结束、结束后30 min,1 h,2 h检测活化凝血时间。结果:肝素组用药后ACT值迅速升高,然后逐渐下降,用药后各时间点ACT值均高于用药前,差异有显著统计学意义(P均(0.05),肝素组用药后各时间点标准差均大于比伐卢定组;国产注射用比伐卢定组用药后ACT值迅速升高,用药后10 min、用药结束及结束后0.5 h与用药前相比较,差异有显著统计学意义(P均(0.05),用药结束后1 h及2 h与用药前相比较,差异均无显著统计学意义(P均>0.05)。结论:与常规肝素抗凝相比,国产注射用比伐卢定在PCI术中可以获得更稳定的抗凝效果,其作为抗凝剂用于PCI术中是安全有效的。

Objective：To investigate the effects of heparin and domestic bivalirudin on coagulation during percutaneous coronary intervention（PCI）.Methods： Sixty selected PCI candidates were randomized into heparin group（n=30） and bivalirudin group（n=30）.They were treated with either intravenous heparin or domestic bivalirudin as anticoagulants during PCI procedures.ACT was measured before the procedure,at 10 min after the first injection,the end of procedure,at 30 min,1 h and 2 h after procedures,respectively.Results： In heparin group,ACT was rapidly prolonged after intravenous heparin injection,and then shorten gradually but it still kept remarkable prolonged until 2 h after procedures as compared with that before the procedures（P〈0.05）.However,the standard deviation of ACT was greater in heparin group than in bivalirudin group.In bivalirudin group,ACT was rapidly prolonged after first bolus and maintained at stable status until 30 min after the infusion（P〈0.05）,and then went back to baseline level.Conclusion： Compared with heparin,domestic bivalivudin is a more stable and effective anticoagulant.