比伐卢定在糖尿病合并ST段抬高性心梗中的有效性及安全性分析

The analysis of effectiveness and safety of bivalirudin in diabetes mellitus with ST-segment elevation myocardial infarction

目的评估比伐卢定在糖尿病合并STEMI的高危人群中的有效性与安全性。方法选取2012年6月-2013年6月连续在我院行PCI的糖尿病合并STEMI患者72例为研究对象,并将其分为比伐卢定组（36例）和肝素加替罗非班组（36例）,比较两组患者术后住院内参数和30 d发生事件。结果住院期间两组患者的心衰、胸痛、ST段回落不良的发生率以及TIMI主要出血事件差异均无统计学意义（P〉0.05）,但两组TIMI轻微出血事件比较,比伐卢定组要优于肝素加替罗非班组（P〈0.05）;两组在30 d中的MACE率、死亡率、再次心梗率以及靶血管再灌注率无显著差异（P〉0.05）,但比伐卢定组的TIMI主要出血及轻微出血事件要显著低于对照组（P〈0.05）。结论比伐卢定在糖尿病合并STEMI的高危人群中的应用具有较好临床疗效。

Objective To evaluate the effectiveness and safety of bivalirudin in high risk population of diabetes mellitus with ST-segment elevation myocardial infarction（STEMI）. Methods A total of 72 cases of diabetes mellitus with STEMI who were performed PCI in our hospital from June 2012 to June 2013 were chosen as the research objects, and divided into bivalirudin group（36 cases） and heparin plus tirofiban group（36 cases）. The parameters in hospital and events within 30 days after operation of the two groups were compared. Results There were no significant differences in the incidences of heart failure, chest pain and bad ST-segment resolution of the two groups during hospitalization（P〈0.05）, but the TIMI minor bleeding events in the bivalirudin group were superior to those of the heparin plus tirofiban group（P〈0.05）. There were no significant differences in MACE, mortality, reinfarction rate and target vessel reperfusion rate of the two groups within 30 days（P〉0.05）, but TIMI major bleeding events and minor bleeding events in the bivalirudin group were significantly lower than those in control group（P〈0.05）. Conclusion Bivalirudin has better clinical effects in the application in high risk population of diabetes mellitus with STEMI.