磺达肝癸钠治疗出血高风险急性冠脉综合征患者的临床研究

Fondaparinux in the treatment of acute coronary syndrome patients with high-risk bleeding

目的:观察磺达肝癸钠治疗高风险出血急性冠脉综合征(ACS)患者的疗效及安全性。方法:根据CRUSADE积分标准筛选出血高危和极高危ACS患者150例,随机分为磺达肝癸钠组(n=50)、依诺肝素组(n=50)和未抗凝组(n=50),观察各治疗组的1个月内主要不良心血管事件(MACE)及住院期间出血发生率。结果:磺达肝癸钠组与依诺肝素组1个月内MACE发生率无差异(9%对10%,P>0.05),未抗凝组MACE发生率较高(15%)。磺达肝癸钠组与未抗凝组住院期间出血发生率明显低于依诺肝素组(20%对10%,P<0.05)。结论:在出血高风险的ACS患者中,磺达肝癸钠可有效降低近期MACE发生率,而不增加出血发生率,比依诺肝素更安全。

Objective：To observe the eficiacy and safety of fondaparinux in the treatment of acute coronary syndrome （ACS）patients with high risk of bleeding. Methods One hundred and fifty consecutive ACS patients were randomly divided into three groups according to different anticoagulant treatment regimen fondaparinux group（n = 50）, enoxaparin group（n = 50）, no-anticoagulant group（n = 50）. All patients were chosen by CRUSADE scores higher or equal to 41. In hospital beleeding rate and major adverse cardiovascular events （MACE） within one month were observed and compared among the three groups. Results： There was no significant difference in rates of MACE during one-month follow- up between the fondaparinux and no-anticoagulart groups （P 〉 0. 05）. The rate of MACE in fondaparinux group was lower than in no-anticoagulant group （P〈0.05）. Compared with enoxaparin group,bleeding rates in fondaparinux and enoxaparin groups were lower （P〈0.05） and the difference of bleeding rates between fondaparinux and enoxaparin group had no statistical significance. Conclusion： Fondaparinux can effectively reduce the incidence of MACE in short term without increasing the incidence of bleeding event in ACS patients with high risk of bleeding. It is safer and more effective than enoxaparin.