磺达肝癸钠在65岁以上急性心肌梗死患者中的临床应用研究

Comparison of Fondaparinux in Age above 65 year-old Patients with Acute Coronary Syndrome

目的:对比磺达肝癸钠(商品名:安卓,葛兰素史克)与那曲肝素(商品名:速碧林,葛兰素史克)在65岁以上急性心肌梗死患者中的有效性和安全性。方法:入选急性心肌梗死住院患者84例随机分为实验组(安卓2.5 mg每天一次皮下注射7天,n=45)和对照组(速碧林,5000 IU(0.4 ML),每天2次皮下注射7天,n=39),随访1个月。对比实验组和对照组抗凝效果。比较两组住院期间及治疗1个月内心源性死亡发生率及出血发生率。结果 :(1)实验组与对照组相比,在治疗1周,心源性死亡发生率显著降低,两者差异有统计学意义(P<0.05)。1个月时,两组比较无统计学意义(P>0.05)(2)出血发生率,实验组较对照组显著降低,轻中度出血发生率有统计学意义(P<0.05)。严重出血发生率有统计学意义(P<0.05)。结论:在急性心肌梗死患者治疗中,磺达肝癸钠与那曲肝素相比更安全有效。

Objective： To compare the efficacy and safty between fondaparinux and fraxiparine in age above 65 year-old patients with acute myocardial infarction.Methods： Eighty-four patients with acute myocardial infarction were randomly divided into two groups： experimental group（n=45,fondaparinux,2.5 mg,subcutaneous injection,one time a day） and control group（n=39,fraxiparine,5000 IU,subcutaneous injection,twice a day）.All patients were treated for seven days and followed up for one month.The anticoagulation effect,incidence of major adverse cardiovascular events（MACE） and bleeding were compared between the two groups during hospitalization and after one month treatment.Results：（1） Compared with the control group,the cardiac mortality rate was lower in the experimental group after one week treatment,（P 0.05）.But there was no significant difference between the two groups after one month treatment in mortality,（P 0.05）.（2） Compared with the control group,the reduction of incidence of slight bleeding and interme-diate bleeding in experimental group was greater,（P 0.05）.And the reduction of incidence of serious bleeding was significantly greater,（P 0.05）.Conclusion： The fondaparinux was more effective and safer than fraxiparine in acute myocardial infarction.