IABP置入下行急诊PCI术患者使用磺达肝癸钠的有效性与安全性研究

Efficacy and safety of fondaparinux Na in treatment of acute coronary syndrome patients with emergency percutaneous coronary intervention supported by IABP

目的:探讨急性冠状动脉综合征(ACS)患者在主动脉内球囊反搏术(intra-aortic balloon pump,IABP)下行急诊冠状动脉内支架置入术后,使用磺达肝癸钠的安全性与有效性。方法:入选ACS并在IABP下行急诊冠状动脉内支架置入术的患者152例,根据所用抗凝药物的不同,分为磺达肝癸钠组和低分子肝素钙组,术后分别给予皮下注射磺达肝癸钠2.5mg/d或低分子肝素钙0.4ml(4 000AIU抗Xa因子),每天两次,均用至出院或术后第8d。收集相关临床资料,记录下肢静脉血栓形成情况,并对两种药物使用后的安全性与疗效进行评估。结果:①两组患者均未见IABP球囊表面血栓形成以及制动的下肢静脉血栓形成;②与低分子肝素钙组比,磺达肝癸钠组的30d内不良心血管事件的发生率较低,差异无统计学意义;出血事件发生率降低(P<0.05)。结论:磺达肝癸钠在IABP置入下的ACS患者能有效地预防血栓形成,30d内的不良心血管事件发生率与出血风险降低,值得在临床上推广。

Objective：To investigate the efficacy and safety of fondaparinux Na in treatment of acute coronary syndrome（ACS）patients with emergency percutaneous coronary intervention（PCI）supported by intra-aortic balloon pump（IABP）.Method：One hundred and fifty two patients with ACS combined with cardiogenic shock were selected.All the patients were randomly assigned to receive either fondaparinux Na or Low molecular weight heparin calcium（LMWH）.In fondaparinux Na group,eighty eight patients were given fondaparinux Na 2.5mg per day subcutaneously for 8days or until discharge,and in LMWH group sixty four patients were treated with LMWH 0.4ml subcutaneously every 12hours for 8days or until discharge.Clinical datas were collected,the incidence of deep vein thrombosis was recoreded.Efficacy and safety of fondaparinux Na versus LMWH in patients with ACS were evaluated.Result：There were no IABP balloon surface and Lower extremity venous thrombosis in both groups.The 30dincidence of major cardiovascular events in fondaparinux sodium group was lower than that in LMWH group,but the difference was not statistically significant.However,the bleeding event rate in fondaparinux sodium group was significantly lower than that in LMWH group（P〈0.05）.Conclusion：In ACS patients who receive emergency PCI suppored with IABP,fondaparinux sodium can effectively prevent thrombosis and reduce the incidence of adverse cardiovascular events within 30days and the risk of bleeding.