在IABP辅助下行PCI的急性心肌梗死患者使用比伐芦定进行治疗的效果及对其血小板水平的影响

Effect of bivalirudin on iABP-assisted PCI in patients with acute myocardial infarction and its influence on platelet level

目的:研究在主动脉内球囊反博术(IABP)辅助下行经皮冠状动脉介入术(PCI)的急性心肌梗死患者使用比伐芦定进行治疗的效果及对其血小板水平的影响。方法:选取100例在IABP辅助下行PCI的急性心肌梗死患者,按照随机数表法将其分为观察组和对照组(50例/组)。为对照组患者采用肝素进行治疗,为观察组患者采用比伐芦定进行治疗,然后比较两组患者不同时间点(行PCI前、给药5 min后、术后即刻、停药后30 min、停药后60 min、停药后120 min)的活化凝血时间、手术前后的血小板水平和治疗后主要心脏不良事件(MACE)的发生率。结果:1)两组患者行PCI前、给药5 min后、术后即刻的活化凝血时间相比,差异无统计学意义(P>0.05)。观察组患者停药后30 min、停药后60 min、停药后120 min的活化凝血时间均短于对照组患者,差异有统计学意义(P<0.05)。2)在术前,两组患者血小板计数的水平相比,差异无统计学意义(P>0.05)。在术后,观察组患者血小板计数的水平高于对照组患者,差异有统计学意义(P<0.05)。3)治疗后,观察组患者MACE的发生率低于对照组患者,差异有统计学意义(P<0.05)。结论:在IABP辅助下行PCI的急性心肌梗死患者使用比伐芦定进行治疗的效果较好,可有效改善其活化凝血时间,且不会影响其血小板计数的水平,安全性较高。

Objective:To study the effect of bivalirudin and its influence on platelet level in patients with acute myocardial infarction who underwent percutaneous coronary intervention(PCI)assisted by intraaortic balloon revascularization(IABP).Methods:100 patients with acute myocardial infarction who underwent PCI assisted by IABP were selected and divided into observation group and control group(50 cases/group)according to random number table method.Patients in the control group were treated with heparin,patients in the observation group were treated with bivalirudin,Then,the activated coagulation time,platelet levels before and after surgery,and the incidence of major adverse cardiac events(MACE)after treatment were compared between the two groups at different time points(before PCI,5 min after administration,immediately after surgery,30 min after withdrawal,60 min after withdrawal,and 120 min after withdrawal).Results:1)There was no statistical significance in the activated coagulation time before PCI,5 min after administration and immediately after surgery between the two groups(P>0.05).The activated coagulation time of observation group was shorter than that of control group 30 min,60 min and 120 min after drug withdrawal,and the difference was statistically significant(P<0.05).2)Before surgery,there was no significant difference in platelet count between 2 groups(P>0.05).After surgery,the level of platelet count in the observation group was higher than that in the control group,the difference was statistically significant(P<0.05).3)After treatment,the incidence of MACE in observation group was lower than that in control group,the difference was statistically significant(P<0.05).Conclusions:In patients with acute myocardial infarction undergoing IABP-assisted PCI,bivalirudin has a better therapeutic effect,which can effectively improve the activated coagulation time,and does not affect the level of platelet count,with high safety.