摘要
目的 :报告GPIIb/IIIa拮抗剂integrilin在经皮冠状动脉支架成形术围术期运用的方法和结果。方法 :9例接受经皮冠状动脉支架成形术患者动脉穿刺完成后即刻注入Integrilin 1 80 μg/kg ,然后按 2 μg/kg/min维持 ,维持时间为 1 2h ,联合应用阿司匹林、Plavix、肝素等其他抗凝和抗血小板药物。常规监测ACT、PT和KPTT ,出院前及术后 1月复查血细胞各 1次。结果 :全部患者均在术后 2 -4h拔除鞘管 ,无穿刺部位显著血肿形成者 ,无冠状动脉急性和亚急性血栓形成者。术后血小板无显著改变 ,术后 8例患者ACT在 2h内和 1例在 4h内恢复至≤ 1 50 ,KPTT在术后 2h与术前相比有显著性差异 ,PT和血小板记数术前、术后无显著性改变。术后随访 3-4月 ,无心绞痛症状复发者。结论 :GPIIb/IIIa拮抗剂integrilin在经皮冠状动脉支架成形术围术期运用 ,结合抗血小板药物Plavix和阿司匹林 ,能显著减少肝素用量和缩短运用时间 ,缩短血管鞘的留置时间 ,而未显示增加出血危险性 ,也未发生支架内血栓形成者。
OBJECTIVE:To reporte the application of GP IIb/IIIa receptor antagonist(integrilin) in peri percutaneous transluminal catheter angioplasty and stent implantation.METHOD:Nine patients who underwent percutaneous transluminal angioplasty and stent implantation were included.After arterial puncture,integrilin was injected at the dose of 180μg/kg,and then maintained at 2μg/kg/min for 12 hours.Aspirin,plavix and heparin were used at the same time.ACT,PT,KPTT and blood routine were routinely monitored.RESULTS:All sheaths were drawn out 2 to 4 hours after the procedure.There was no severe complication such as hematoma,acute and subacute thrombosis in coronary artery,or thrombocytopenia.ACT returned to less than 150 in 2 hours in 8 patients,in 4 hours in 1 patient.There were no significant difference between the pre and post procedure value of PT and platelet count.KPTT was significantly higher than pre procedure value at 2 hours after the procedure.No recurrence of angina pectoris were observed within 3 to 4 months follow up.CONCLUSION:Application of GP IIb/IIIa receptor antagonist(Integrilin) in peri percutaneous transluminal catheter angioplasty and stent implantation in combination with aspirin and plavix could significantly reduce the dosage and duration of heparin with benefit of shortening the indwelling time of sheaths,but did not increase the risk of bleeding or lead to thrombosis in stent.
出处
《中国现代应用药学》
CSCD
2000年第5期406-408,共3页
Chinese Journal of Modern Applied Pharmacy
