依诺肝素在急性冠脉综合征介入治疗中的应用

Effect of enoxaparin pretrcatlnent in percutaneous coronary intervention for acute coronary syndrome

目的:旨在对比依诺肝素(克塞)预处理下的急性冠脉综合征(ACS)病人在行经皮冠脉介治疗(PCI)术中普通肝素小剂量用法与常规剂量用法的疗效。方法:60例在克塞预处理72小时后的ACS患者,在行PCI时,术中使用普通肝素3000 IU(小剂量肝素组,S组)与10 000 IU(常规剂量肝素组,R组)各30例。对比观察术后两组凝血酶原时间PT)、部分凝血时间(APTT)、肌钙蛋白I(TnI)、再梗死率、出血情况、死亡率。结果:两组术后PT、APTT、TnI、死亡率、再梗死率、严重出血率均无显著性差异(P>0.05);轻微出血率S组显著低于R组(3.3%、26.7%.P<0.05)。结论:皮下克塞预处理在ACS患者可为PCI提供足够的抗凝作用,且减少副作用。

Objective: To compare curative effect of small dosage and common dosage of unfractionatcd heparins in percutaneous coronary intervention (PCI) after enoxaparin (clexane) prelreatment for patient with acute coronary syndrome (ACS). Methods:A total of 60 cases accepted PCI after enoxaparin pretrcatment for 72 hours. Thirty cases used small dosage (3000 IU group S) heparin and other 30 cases used common dosage (10000 IU . group R). Compare curative effect of two groups. Results: Statistic analysis showed the prothrombin time (PT)、 apart prothrombin time (APTT)、troponin (TnI)、death rate、 re-infarct rate and major hemorrhage were same for two groups (P>0. 05); But minor bleeding rate in group S was less(3. 3%) than group R(26. 7%). Conclusion: Results suggest subcutaneous enoxaparin prctreatment for 72 hours can provide enough anticoagulant and reduce side effect.