不同途径注射比伐芦定对急性冠脉综合征患者行介入治疗的疗效及安全性评价被引量：11

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摘要目的探讨经冠脉和经外周静脉注射比伐芦定对急性冠脉综合征(ACS)患者经皮冠状动脉介入治疗(PCI)后即刻疗效和随访期间发生主要心脏不良事件(MACE)的影响。方法入选本院150例诊断为急性冠脉综合征的住院患者,均行介入治疗。采用随机数字表法分为A、B、C三组,每组50例(A组:经外周静脉+冠脉内注射比伐芦定组;B组:经外周静脉注射比伐芦定组;C组:常规肝素治疗组)。随访3个月,比较三组患者PCI术中活化凝血时间(ACT)达标率及发生无复流/慢血流的情况,住院期间及随访3个月发生心绞痛、再发心肌梗死、心力衰竭、靶血管再次血运重建率、心源性死亡等MACE的情况以及出血事件的发生率。结果 A、B组PCI术中ACT达标率均高于C组(P<0.05)。介入治疗术中A组校正的TIMI血流帧数计数(CTFC)及TIMI心肌灌注分级(TMP)优于B组和C组(P < 0. 05 ), B组与C组比较差异无统计学意义(P >0.05)。随访3个月,A组总MACE发生率明显少于B组和C组(P<0.05),而B组、C组差异无统计学意义(P>0.05)。A组、B组出血事件均明显少于C组,A组与B组之间差异无统计学意义(P >0. 05),三组均无死亡事件发生。结论对于ACS患者行PCI时,经冠脉内注射和经外周静脉注射比伐芦定,术中均能获得更高的ACT达标率。经冠脉内注射可获得更好的心肌微循环再灌注,可显著减少3个月心脏不良事件的发生,且不增加出血事件。

作者纪军何胜虎陈述徐日新刘晓东徐冰张建秋

机构地区江苏省苏北人民医院心内科

出处《中国医师杂志》 CAS 2019年第6期923-925,共3页 Journal of Chinese Physician

关键词水蛭素类急性冠状动脉综合征注射静脉内注射动脉内

分类号 R541.4 [医药卫生—心血管疾病]

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