摘要
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。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。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)。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。
Objective： To observe the efficacy and safety of bivalirudin on primary percutaneous coronary intervention （PCI） in patients with acute ST-elevation myocardial infarction （STEMI）. 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. 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% all P〉0.05. 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.
出处
《中国循环杂志》
CSCD
北大核心
2015年第8期737-740,共4页
Chinese Circulation Journal
