摘要
目的观察和对比比伐卢定与替罗非班联合肝素在急诊经皮冠状动脉介入(PCI)治疗中的疗效与安全性。方法选取90例行急诊PCI治疗的急性ST段抬高型心肌梗死(STEMI)患者作为研究对象,将其随机分为观察组和对照组,每组45例。观察组患者于术前静脉给予比伐卢定进行辅助治疗,对照组患者于术前静脉给予替罗非班联合肝素进行辅助治疗。对2组患者术后心电图ST段回降幅度、心肌梗死溶栓治疗临床试验(TIMI)血流分级及出血并发症的发生情况进行观察和比较。结果 2组患者急诊PCI术后ST段回降百分比分布和梗死血管血流TIMI分级的差异均无统计学意义(χ2=0.212、0.690,P>0.05),但观察组患者急诊PCI术后活动性出血的发生率及咯血的发生率均显著低于对照组(χ2=7.283、3.873,P<0.05)。结论在STEMI患者的急诊PCI治疗中,应用比伐卢定的术后出血并发症的发生率较低,安全性较高。
Objective To observe and compare the therapeutic effects and safety of bivalirudin and tirofiban combined with heparin in percutaneous coronary intervention（ PCI） treatment in the emergency department. Methods A total of 90 patients with acute ST segment elevation myocardial infarction（ STEMI） treated with PCI in emergency department were randomly divided into observation group and control group,45 cases in each group. The patients in the observation group were treated with preoperative intravenous administration of bivalirudin,while the patients in the control group were treated with preoperative intravenous administration of tirofiban combined with heparin. The fall range of ST segment in ECG,the thrombolysis in myocardial infarction（ TIMI） blood flow grades and the hemorrhage complications after the treatment were observed and compared between two groups.Results There were no significant differences of distribution of the fall percentage of ST segment and TIMI grades after the treatment between the two groups（ χ2= 0. 212,0. 690,P〈0. 05）,but the incidence rate of postoperative active hemorrhage complications and hemoptysis in the observation group were significantly lower than those in the control group（ χ2= 7. 283,3. 873,P〈0. 05）. Conclusion In PCI treatment of the patients with STEMI,the application of bivalirudin can reduce incidence rate of the postoperative hemorrhage complications and achieve a higher security.
出处
《实用临床医药杂志》
CAS
2016年第3期36-39,共4页
Journal of Clinical Medicine in Practice
关键词
急性ST段抬高型心肌梗死
急诊经皮冠状动脉介入
比伐卢定
替罗非班
普通肝素
安全性观察
acute ST segment elevation myocardial infarction
percutaneous coronary intervention in the emergency department
bivalirudin
tirofiban
common heparin
safety observation
