摘要
目的评估比伐芦定应用于急性冠状动脉综合征(ACS)行经皮冠状动脉介入治疗(PCI)患者的疗效及安全性。方法本研究入选了2012年5月至2013年2月于沈阳军区总医院接受PCI的ACS患者119例,根据PCI术中用药分为比伐芦定组60例和普通肝素组59例。主要观察住院期间出血事件,随访30 d、1年患者主要不良心血管事件(MACE)。结果两组患者基线资料比较,差异无统计学意义(P〉0.05)。冠状动脉造影显示,比伐芦定组双支血管病变比例显著高于普通肝素组(36.7%比16.9%,P=0.015);三支血管病变比例较普通肝素组显著偏低(51.6%比72.9%,P=0.017);血管长病变(病变长度≥20 mm)比例显著高于普通肝素组(55.0%比32.2%,P=0.012)。比伐芦定组改善了PCI术后出血事件发生率(3.3%比8.5%,P=0.422),且PCI术后血小板下降幅度明显低于普通肝素组[(9.5±6.1)×10~9/L比(12.1±7.1)×10~9/L,P=0.036]。随访期间两组患者MACE发生率比较,差异无统计学意义(P〉0.05)。结论比伐芦定在行PCI术的ACS患者中是安全、有效的。
Objective To evaluate the efficacy and safety of the direct thrombin inhibitor bivalirudin in patients with acute coronary syndromes(ACS) undergoing percutaneous coronary intervention(PCI).Methods In this single center study,we evaluated 119 patients with acute coronary syndrome who underwent percutaneous coronary intervention between May 2012 to February 2013.Base on the therapy during PCI,bivalirudin was used in 60 patients and heparin was used in 59 patients.The outcomes studied included rates of in-hospital thrombocytopenia,bleeding events myocardial infarction,repeat revascularization,incidence of cardiac death in 30 days and 1 year.Results No significant difference was observed in baseline clinical data between the two groups(P〉0.05).After angiography and compared to the heparine group,there was higher percentege of double-vessle disease(36.7%vs.16.9%,P =0.015),less triple-vessle disease(51.6%vs.72.9%,P=0.017) and more long lesions(coronary lesion length ≥20 mm,55.0%vs.32.2%,P =0.012) in the bivalimudin group.Bivalirudin group had a lower rate of in-hospital bleeding than the heparin group(3.3%vs.8.5%,P =0.422).The degree of decrease in platelet count after PCI in bivalirudin group was lower than the heparin group[(9.5 ± 6.1) × 10~9/L vs.(12.1 ±7.1) ×10~9/L,P=0.036].In the follow-up period,the rates of MACE events were of no differences between the two groups(P〉0.05).Conclusions Bivalirudin is effective and safe in patients with ACS who underwent PCI.
出处
《中国介入心脏病学杂志》
2015年第9期481-486,共6页
Chinese Journal of Interventional Cardiology
基金
辽宁自然科学基金(201102241)