摘要
目的探讨比伐芦定对老年冠心病患者经皮冠脉介入术(PCI)后慢血流/无复流治疗效果。方法收集2019年8月至2021年10月杭州市第九人民医院收治的行急诊PCI治疗中发生慢血流/无复流的老年冠心病患者146例,采用数字奇偶法分为研究组(比伐芦定治疗,73例)和对照组(普通肝素治疗,73例)。比较两组PCI术后冠状动脉TIMI血流分级、凝血功能[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)]、血小板最大聚集率(MPAR)及微循环功能相关指标[冠状动脉血流储备(CFR)、微循环抵抗指数(IMR)]。比较两组PCI治疗后30 d内主要心血管不良事件(MACE)和出血事件。结果研究组血流分级优于对照组(P<0.05)。治疗后两组PT、APTT、TT均升高,MPAR均降低,且研究组PT、APTT、TT高于对照组,MPAR低于对照组(P<0.05)。治疗后两组CFR、IMR均升高,且研究组CFR高于对照组,IMR低于对照组(P<0.05)。研究组MACE总发生率、出血率均低于对照组(P<0.05)。结论在老年冠心病患者PCI治疗中应用比伐芦定可改善患者慢血流/无复流、凝血功能及微循环功能、调控MPAR,并可降低术后MACE和出血发生率。
Objective To investigate the effect of Bivalrudin on the treatment of slow blood flow/no-reflow in elderly patients with coronary heart disease after percutaneous coronary intervention(PCI).Methods A total of 146 elderly patients with coronary heart disease with slow blood flow/no-reflow during emergency PCI who were admitted to Hangzhou Ninth People’s Hospital from August 2019 to October 2021 were collected,and theye were divided into the study group(treated with Bivalrudine,73 cases)and control group(treated with unfractionated heparin,73 cases)by digital parity method.Coronary artery TIMI blood flow classification and coagulation function(prothrombin time[PT],activated partial thromboplastin time[APTT],thrombin time[TT],the maximum platelet aggregation rate(MPAR)and related indicators of microcirculation function(coronary artery blood flow reserve[CFR],microcirculation resistance index[IMR])in two groups after PCI were compared.Major adverse cardiac events(MACE)and bleeding events within 30 days after PCI were compared between the two groups.Results Blood flow grading in the study group was better than that in the control group(P<0.05).After treatment,PT,APTT,and TT increased in both groups,while MPAR decreased.PT,APTT,and TT in the study group were higher than those in the control group,while MPAR was lower than that in the control group(P<0.05).After treatment,CFR and IMR in the two groups were increased,and CFR in the study group were higher than those in the control group,and IMR was lower than the control group(P<0.05).The total incidence and bleeding rate of MACE in the study group were lower than those in the control group(P<0.05).Conclusion The application of Bivalrudin during PCI in elderly patients with coronary heart disease can improve patients’slow blood flow/no-reflow,coagulation function and microcirculation function,regulate MPAR,and reduce the incidence of MACE and bleeding after surgery.
作者
范玲珑
张义林
FAN Linglong;ZHANG Yilin(Department of Cardiovascular Medicine,Hangzhou Ninth People’s Hospital,Zhejiang Province,Hangzhou 311225,China)
出处
《中国医药导报》
CAS
2022年第23期62-65,共4页
China Medical Herald
基金
浙江省医药卫生科技计划项目(2020KY822)。
关键词
比伐芦定
老年
冠心病
经皮冠脉介入术
慢血流
无复流
Bivarudin
Elderly
Coronary heart disease
Percutaneous coronary intervention
Slow blood flow
No reflow
