CAJ | 학술논문

目的研究急性冠状动脉综合征患者在经皮冠状动脉介入治疗前应用那屈肝素的合适剂量并评估其安全性.方法 236例急性冠状动脉综合征高危患者随机分为Ⅰ组(那屈肝素0.075ml/10 kg,120例)和Ⅱ组(那屈肝素0.1 ml/10 kg,116例).两组给予相应剂量那屈肝素,每12 h皮下注射1次,至少48 h,最后一次注射1 h后行经皮冠状动脉介入治疗,术中不再追加那屈肝素.分别在末次注射前、注射后1 h、2 h、4 h、6 h、8 h测定血浆抗Xa因子活性.观察记录患者30 d内的主要心脏不良事件(死亡、再梗死、血运重建)及出血事件.结果两组的一般临床资料、30 d内随访主要心脏事件及出血发生率差异均无统计学意义(P>0.05).各时间点血浆抗Xa因子活性Ⅱ组高于Ⅰ组,差异有统计学意义(P<0.01).结论在急性冠状动脉综合征介入治疗前应用两种剂量那屈肝素均能达到有效的抗凝效果.
목적 연구급성관상동맥종합정환자재경피관상동맥개입치료전응용나굴간소적합괄제량병평고기안전성.방법 236례급성관상동맥종합정고위환자수궤분위Ⅰ조(나굴간소0.075ml/10 kg,120례)화Ⅱ조(나굴간소0.1 ml/10 kg,116례).량조급여상응제량나굴간소,매12 h피하주사1차,지소48 h,최후일차주사1 h후행경피관상동맥개입치료,술중불재추가나굴간소.분별재말차주사전、주사후1 h、2 h、4 h、6 h、8 h측정혈장항Xa인자활성.관찰기록환자30 d내적주요심장불량사건(사망、재경사、혈운중건)급출혈사건.결과 량조적일반림상자료、30 d내수방주요심장사건급출혈발생솔차이균무통계학의의(P>0.05).각시간점혈장항Xa인자활성Ⅱ조고우Ⅰ조,차이유통계학의의(P<0.01).결론 재급성관상동맥종합정개입치료전응용량충제량나굴간소균능체도유효적항응효과.
Objective To evaluate the safety and optimal piror pereutaneous coronary intervention (PCI) natroparin dose in patients with acute coronary syndrome (ACS).Methods A total of 236 ACS patients were randomly treated with subcutaneously natroparin 0.075 ml/10 kg(group I,n=120) and 0.1 ml/10 kg(group Ⅱ,n=116) respectively (bid for 48 hours).PCI was the performed 1 h after final natroparin injection.No additional natroparin wag applied during PCI.Plasmic anti-Xa level was assayed before and at 1,2,4 and 8 hours after final natroparin administration.Adverse clinical events (death,myocardial infarction,need for revasculafization) and bleeding events were recorded up to 30 days post PCI.Results Baseline clinical characteristics as well as the MACE and severe bleeding events between the two groups were similar(all P>0.05).Plasmic anti-Xa level of group Ⅱ was significantly higher than that of group I post natroparin application (P<0.01).Conclusion Anticogulation effects and MACE as well fits severe bleeding events up to 30 chys post PCI were similar with either 0.075 ml/lO kg or 0.1 ml/10 kg natroparin dose in ACS patients.