比伐卢定与替罗非班、肝素在STEMI患者经皮冠状动脉介入术围术期抗凝中的应用效果

Application effect of bivalirudin and tirofiban and heparin in perioperative anticoagulation of STEMI patients undergoing percutaneous coronary intervention

目的探究比伐卢定与替罗非班、肝素在ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入术(PCI)围术期抗凝中的应用效果。方法选取2018年1月至2019年1月收治的200例STEMI患者为研究对象,患者均接受PCI治疗,根据围术期抗凝方案的不同将其分为试验组(n=150,比伐卢定)和对照组(n=50,替罗非班+肝素)。比较两组的治疗效果。结果治疗后,两组的血流分级比较,差异无统计学意义(P>0.05)。试验组的出血事件发生率明显低于对照组(P<0.05);两组再发心肌梗死、支架内狭窄、心力衰竭的发生率比较,差异无统计学意义(P>0.05)。术后,两组的P选择素水平均降低,GMP-140水平均升高(P<0.05),但组间比较,差异无统计学意义(P>0.05)。结论比伐卢定与替罗非班、肝素在STEMI患者PCI围术期抗凝中均可获得较好的应用效果,改善患者的冠状动脉血流,但应用伐卢定还可降低患者出血事件的发生率,安全性更优。

Objective To explore the application effect of bivalirudin and tirofiban and heparin in perioperative anticoagulation of ST segment elevation myocardial infarction(STEMI)patients undergoing percutaneous coronary intervention(PCI).Methods A total of 200 patients with STEMI admitted from January 2018 to January 2019 were selected as the research objects.All patients received PCI,and they were divided into experimental group(n=150,bivalirudin)and control group(n=50,tirofiban+heparin)according to perioperative anticoagulation regimen.The therapeutic effects of the two groups were compared.Results After treatment,there was no significant difference in blood flow classification between the two groups(P>0.05).The incidence of bleeding events in the experimental group was significantly lower than that in the control group(P<0.05);there were no significant differences in the incidences of recurrent myocardial infarction,stent stenosis and heart failure between the two groups(P>0.05).After operation,the P-selectin level of the two groups decreased,and the GMP-140 level increased(P<0.05),but there were no significant differences between the two groups(P>0.05).Conclusion Bivalirudin and tirofiban and heparin in perioperative anticoagulation of STEMI patients have a good application effect,it can improve coronary blood flow of patients,but the application of varrudin can also reduce the incidence of bleeding events in patients,with better safety.