中国循环杂志
中國循環雜誌
중국순배잡지
CHINESE CIRCULATION JOURNAL
2015年
8期
737-740
,共4页
吴佳纬%马礼坤%杨喆%范海
吳佳緯%馬禮坤%楊喆%範海
오가위%마례곤%양철%범해
比伐芦定%肝素%急性ST段抬高型心肌梗死%经皮冠状动脉介入治疗%血小板糖蛋白Ⅱb/Ⅲa受体拮抗剂
比伐蘆定%肝素%急性ST段抬高型心肌梗死%經皮冠狀動脈介入治療%血小闆糖蛋白Ⅱb/Ⅲa受體拮抗劑
비벌호정%간소%급성ST단태고형심기경사%경피관상동맥개입치료%혈소판당단백Ⅱb/Ⅲa수체길항제
Bivalirudin%Heparin%ST-elevation myocardial infarction%Percutaneous coronary intervention%Glycoprotein IIb/IIIa inhibitor
目的：观察比伐芦定在急性ST段抬高型心肌梗死（STEMI）患者急诊经皮冠状动脉（冠脉）介入治疗（PCI）术中应用的有效性及安全性。<br> 方法：选择2011-09至2014-01期间因急性STEMI就诊于我院并行急诊PCI术的患者159例，根据术中是否使用比伐芦定随机分为两组：比伐芦定组及肝素组。术中血小板糖蛋白Ⅱb/Ⅲa受体拮抗剂（GPI）即替罗非班的应用由术者评估患者病情特点决定是否合并应用。分析两组一般情况、冠脉影像特点等一系列基线资料，并对两组围手术期及术后30 d内的出血及主要心血管不良事件（MACE）的发生情况进行随访统计，分析比较其中差异。<br> 结果：在最终完成研究的153例样本中，比伐芦定组（n=72）与肝素组（n=81)比较，围手术期出血事件发生率6.5%比11.0%、支架内血栓事件发生率0%比1.2%以及术后30 d内的出血事件发生率9.7%比13.5%、 MACE发生率1.4%比7.4%均有所下降，但两组差异均无统计学意义（P均>0.05）。<br> 结论：比伐芦定应用于急性STEMI患者急诊PCI术中是安全有效的，且其具有降低出血及MACE发生率的趋势。
目的：觀察比伐蘆定在急性ST段抬高型心肌梗死（STEMI）患者急診經皮冠狀動脈（冠脈）介入治療（PCI）術中應用的有效性及安全性。<br> 方法：選擇2011-09至2014-01期間因急性STEMI就診于我院併行急診PCI術的患者159例，根據術中是否使用比伐蘆定隨機分為兩組：比伐蘆定組及肝素組。術中血小闆糖蛋白Ⅱb/Ⅲa受體拮抗劑（GPI）即替囉非班的應用由術者評估患者病情特點決定是否閤併應用。分析兩組一般情況、冠脈影像特點等一繫列基線資料，併對兩組圍手術期及術後30 d內的齣血及主要心血管不良事件（MACE）的髮生情況進行隨訪統計，分析比較其中差異。<br> 結果：在最終完成研究的153例樣本中，比伐蘆定組（n=72）與肝素組（n=81)比較，圍手術期齣血事件髮生率6.5%比11.0%、支架內血栓事件髮生率0%比1.2%以及術後30 d內的齣血事件髮生率9.7%比13.5%、 MACE髮生率1.4%比7.4%均有所下降，但兩組差異均無統計學意義（P均>0.05）。<br> 結論：比伐蘆定應用于急性STEMI患者急診PCI術中是安全有效的，且其具有降低齣血及MACE髮生率的趨勢。
목적：관찰비벌호정재급성ST단태고형심기경사（STEMI）환자급진경피관상동맥（관맥）개입치료（PCI）술중응용적유효성급안전성。<br> 방법：선택2011-09지2014-01기간인급성STEMI취진우아원병행급진PCI술적환자159례，근거술중시부사용비벌호정수궤분위량조：비벌호정조급간소조。술중혈소판당단백Ⅱb/Ⅲa수체길항제（GPI）즉체라비반적응용유술자평고환자병정특점결정시부합병응용。분석량조일반정황、관맥영상특점등일계렬기선자료，병대량조위수술기급술후30 d내적출혈급주요심혈관불량사건（MACE）적발생정황진행수방통계，분석비교기중차이。<br> 결과：재최종완성연구적153례양본중，비벌호정조（n=72）여간소조（n=81)비교，위수술기출혈사건발생솔6.5%비11.0%、지가내혈전사건발생솔0%비1.2%이급술후30 d내적출혈사건발생솔9.7%비13.5%、 MACE발생솔1.4%비7.4%균유소하강，단량조차이균무통계학의의（P균>0.05）。<br> 결론：비벌호정응용우급성STEMI환자급진PCI술중시안전유효적，차기구유강저출혈급MACE발생솔적추세。
Objective: To observe the efifcacy and safety of bivalirudin on primary percutaneous coronary intervention (PCI) in patients with acute ST-elevation myocardial infarction (STEMI). <br> Methods: A total of 159 patients with acute STEMI treated by emergent PCI in our hospital from 2011-09 to 2014-01 were retrospectively studied. The patients were divided into 2 groups according to procedural bivalirudin application as Bivalirudin group and Heparin group, and the application of GPI (glycoprotein IIb/IIIa inhibitor) was decided by the operator. The baseline condition, coronary artery imaging condition, peri-operative and 30-day post-operative bleeding, the occurrence rate of MACE were compared between 2 groups. <br> Results: There were 153 patients completed the follow-up study including 72 in Bivalirudin group and 81 in Heparin group. The peri-operative bleeding rates in Bivalirudin group and Heparin group were 6.5% vs 11.0%, the in-stent thrombosis rates were 0% vs 1.2%, 30-day post-operative bleeding rates were 9.7% vs 13.5% and the occurrence of MACE were 1.4% vs 7.4% allP>0.05. <br> Conclusion: THE application of bivalirudin in emergent PCI is safe and effective in patients with acute STEMI, it has certain trend to reduce bleeding in relevant patients.
