比伐卢定和普通肝素在STEMI患者PCI术中对凝血功能影响及安全性比较.docVIP

比伐卢定和普通肝素在STEMI患者PCI术中对凝血功能影响及安全性比较 　　[摘要] 目的 对比将比伐卢定和普通肝素应用于急性ST段抬高型心肌梗死（STEMI）患者的冠状动脉介入（PCI）术中患者的凝血功能及安全性，并分析其临床意义。 方法 选择2013年1月～2014年1月在我院行PCI手术的STEMI患者共78例，随机将其分为对照组和观察组，对照组患者使用普通肝素注射抗凝，而观察组患者采用比伐卢定注射抗凝。观察两组患者在用药后5 min、术后即刻、停药后30 min、1 h、2 h的激活凝血时间（ACT）。 结果 停药后30 min、1 h、2 h，两组患者的ACT均明显下降，并且比伐卢定组的下降程度更大，差异具有统计学意义（P0.05）。 结论 比伐卢定相比于普通肝素，应用于行PCI手术的STEMI患者效果显著，半衰期更短，且患者术后出血情况较少。 　　[关键词] STEMI；PCI；比伐卢定；普通肝素 　　[中图分类号] R541.4 [文献标识码] B [文章编号] 1673-9701（2015）20-0086-03 　　Comparison of Bivalirudin and Unfractionated heparin on their influence on coagulation function and safety in PCI surgery for STEMI patients 　　LIU Jieru WANG Juwen 　　Department of Cardiology， Xinjiang Autonomous Region Occupational Disease Hospital， Urumqi 830091，China 　　[Abstract] Objective To compare the application of bivalirudin and unfractionated heparin in the percutaneous coronary intervention （PCI） surgery for patients with acute ST-segment elevation myocardial infarction （STEMI） and analyze their clinical significance. Methods A total of 78 patients with acute ST-segment elevation myocardial infarction （STEMI） were randomly divided into the control group and the observation group from January 2013 to January 2014 in our hospital. The control group used unfractionated heparin injection for anticoagulation and the observation group used bivalirudin for anticoagulation. The activated clotting time （ACT） 5 minutes after medication， right after surgery， and 30 minutes， 1 hour and 2 hours after drug withdrawal of the two groups were observed. Results 30 minutes， 1 hour and 2 hours after drug withdrawal， ACT of both groups decreased significantly and the decreasing degree of the bivalirudin group was larger， with statistically significant differences （P0.05）. Conclusion In the PCI surgery for STEMI patients， bivalirudin has more significant effects， shorter half-life period and less postoperative bleeding than unfractionated heparin. 　　[Key words] STEMI； PCI； Bivalirudin； Unfractionated hepa