摘要
目的观察磺达肝癸钠延长期治疗在急性心肌梗死行早期经皮冠状动脉介入治疗（PCI）术后的疗效及安全性。方法选择2011年2月至2012年4月诊治的急性ST段抬高性心肌梗死行早期PCI的患者121例，按随机数字表法分为磺达肝癸钠普通治疗组（A组，40例）、磺达肝癸钠延长期治疗组（B组，41例）和依诺肝素组（C组，40例），三组的基础治疗相同。A组予以磺达肝癸钠2．5mg／d，皮下注射5～7d，平均6．02d；B组予以磺达肝癸钠2．5mg／d，皮下注射lO～15d，平均12．61d；C组予以依诺肝素5000U／12h，皮下注射5—7d，平均6．21d。观察治疗15d内各组不良心血管事件（再发心肌缺血、新发心肌梗死、死亡）的发生情况及出血（皮肤黏膜的轻度出血及内脏器官的严重出血）情况。结果B组死亡、再发心肌缺血、新发心肌梗死及总的不良心血管事件发生率[分别为4．9％（2／41）、0、0、4．9％（2／41）]均低于A组[分别为25．0％（10／40）、12．5％（5／40）、10．0％（4／40）、47．5％（19／40）]、c组[分别为27．5％（11／40）、15．0％（6／40）、12．5％（5／40）、55．0％（22／40）]，差异均有统计学意义（P〈0．05或〈0．01）。C组轻度出血、重度出血及总的出血事件发生率[分别为32．5％（13／40）、15．0％（6／40）、47．5％（19／40）]显著高于A组[分别为10．0％（4／40）、2．5％（1／40）、12．5％（5／40）]、B组[分别为14．6％（6／41）、2．4％（1／41）、17．1％（7／41）]，差异有统计学意义（P〈0．05或〈0．01）。结论磺达肝癸钠延长期治疗可显著降低急性心肌梗死行早期PCI患者不良心血管事件的发生率，且未增加出血风险，安全有效。
Objective To observe the efficacy and safety of fondaparinux sodium prolonged treatment in patients with acute myocardial infarction underwent primary percutaneous coronary intervention （PCI）. Methods A total of 121 patients with acute ST segment elevation myocardial infarction （STEMI） underwent primary PCI from February 2011 to April 2012 were divided into three groups by random digits table method： 40 patients in fondaparinux sodium general treatment group （A group）, 41 patients in fondaparinux sodium prolonged treatment group （B group） and 40 patients in enoxaparin group （C group）. The basic treatment was similar among three groups. The patients in A group were given fondaparinux sodium 2.5 mg/d for 5-7 d, and the averaged time was 6.02 d. The patients in B group were given fondaparinux sodium 2.5 mg/d for 10-15 d, and the averaged time was 12.61 d. The patients in C group were given enoxaparin 5000 U/12 h for 5-7 d, and the averaged time was 6.21 d. Main outcome indexes including re-myocardial ischemia, new-myocardial infarction, death and bleeding were observed within 15 d after treatment. Results The incidence of death, re-myocardial ischemia, new-myocardial infarction and overall cardiovascular events in B group [ 4.9% （2/41 ）, 0, 0, 4.9% （2/41 ） ] were significantly lower than those in A group [25.0%（10/40）, 12.5%（5/40）, 10.0%（4/40）,47.5%（19/40） ] and C group [ 27.5%（11/40）, 15.0% （6/40）, 12.5% （5/40）, 55.0% （22/40） ], and there were significant differences among three groups （P 〈 0.05 or 〈 0.01 ）. The incidence of mild bleeding, severe bleeding and overall bleeding in C group[32.5% （13/40）, 15.0% （6/40）,47.5%（ 19/40）] were significantly higher than those in A group [10.0% （4/40）, 2.5%（1/40）,12.5%（5/40）] and B group [14.6%（6/41）,2.4%（1/41）,17.1%（7/41）], and there were significant differences among three groups （P 〈 0.05 or 〈 0.01 ）. Conclusions Fondaparinux sodium prolonged anticoagulation treatment can significantly reduce overall cardiovascular events in patients with STEMI underwent primary PCI, and does not increase bleeding. It is safe and effective.
出处
《中国医师进修杂志》
2013年第1期7-10,共4页
Chinese Journal of Postgraduates of Medicine
关键词
心肌梗塞
药物疗法
抗凝药
磺达肝癸钠
依诺肝素
Myocardial infarction
Drug therapy
Anticoagulants
Fondaparinux sodium
Enoxaparin
