标题:比伐卢定对急性心肌梗死患者冠脉介入术后预后的影响
作者:陈要起,穆金兴,陈洪波,李雪霞,李延鑫,曹亚冰,齐丽平,朱凌凌 (邢台市第三医院心内科,河北 邢台 054000)
卷次:
2018年29卷9期
【摘要】 目的 探讨比伐卢定对急性心肌梗死(AMI)患者行急诊经皮冠状动脉介入治疗(PCI)术后预后的影响。方法 选择2017年1~5月邢台市第三医院心内科诊治的AMI患者86例作为研究对象,采用随机数表法分为观察组和对照组各43例。所有患者均给予急诊经皮冠脉内介入治疗,对照组患者术中给予肝素钠注射液抗凝治疗;观察组术中给予比伐卢定抗凝治疗至术后4 h,所有患者术后均按照冠心病诊疗规范给予治疗。比较两组患者罪犯血管术后心肌梗死溶栓 (TIMI)血流分级、碎裂QRS波发生率、心脏超声结果及不良事件发生率和再住院率的差异。结果 观察组患者术后罪犯血管TIMI血流3级比例为95.35%,高于对照组的81.40%,差异具有统计学意义(P<0.05);观察组患者碎裂QRS波发生率在术后1周、1个月、3个月时分别为32.60%、34.88%、34.88%,明显低于对照组的 53.49%、60.47%、58.14%,差异均具有统计学意义(P<0.05);观察组患者术后 3个月时左室射血分数为(46.09±5.80)%,高于对照组的(43.62±4.85)%,差异具有统计学意义(P<0.05),而术后3个月时左室舒张末内径、室间隔厚度比较差异无统计学意义 (P>0.05);观察组患者随访3个月总心脏不良事件仅5例,明显少于对照组的15例,再住院次数仅2人次,低于对照组的8人次,差异均具有统计学意义(P<0.05);但两组患者的总出血事件比较差异无统计学意义(P>0.05)。结论 比伐卢定可进一步改善AMI患者PCI术后的预后,值得临床推广应用。
【关键词】 比伐卢定;急性心肌梗死;冠脉动脉介入术;预后
【中图分类号】 R542.2+2 【文献标识码】 A 【文章编号】 1003—6350(2018)09—1199—04
Effects of bivalirudin on prognosis in patients with acute myocardial infarction undergoing percutaneouscoronary intervention.
CHEN Yao-qi, MU Jin-xing, CHEN Hong-bo, LI Xue-xia, LI Yan-xin, CAO Ya-bing, QILi-ping, ZHU Ling-ling. Department of Cardiology, the Third Hospital of Xingtai, Xingtai 054000, Hebei, CHINA
【Abstract】 Objective To evaluate the influence of bivalirudin on the prognosis of patients with acute myocar-dial infarction (AMI) undergoing percutaneous coronary intervention (PCI). Methods A total of 86 patients with AMI,who admitted to Department of Cardiology of the Third Hospital of Xingtai between Janurary 2017 and May 2017, wereselected and divided into the observation group (43 cases) and the control group (43 cases) according to random numbertable method. The two groups were treated with standardized treatment of AMI. The control group received heparin be-fore PCI, and the observation group had bivalirudin infusion until the end of surgery, maintaining at least for four hours.After the treatment, all patients were treated according to the standard of diagnosis and treatment of coronary heart dis-ease. The Thrombolysis In Myocardial Infarction (TIMI) flow grade (TFG), the occurrence dynamics of fragmentedQRS complexes (fQRS), cardiac ultrasound results and incidences of adverse events and rehospitalization rates were re-corded and compared. Results The radio of TIMI blood flow grade 3 was 95.35% in the observation group versus81.40% in the control group (P<0.05). The detection rate of fQRS of the observation group at one week, one month,three months after the treatment were respectively 32.60% , 34.88% , 34.88% versus corresponding 53.49% , 60.47% ,58.14% in the control group (all P<0.05). The left ventricular systolic function indicator (LVEF) was (46.09±5.80)% inthe observation group versus (43.62±4.85)% in control group (P<0.05), while the left ventricular end diastolic diameter·论 著·doi:10.3969/j.issn.1003-6350.2018.09.005
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