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目的观察冠心病患者择期经皮冠状动脉介入治疗(PCI)术中应用比伐芦定的临床效果和安全性。方法将确诊为冠心病的50例患者随机分为观察组和对照组各25例,2组患者均于术后口服阿司匹林和氯吡格雷。观察组在导管室中,开始PCI术前给予比伐芦定0.75mg/kg静脉推注作为负荷剂量,后立即以1.75mg/(kg·h)持续输注至手术结束;对照组术前自鞘管内注射普通肝素,在PCI术后持续静脉滴注替罗非班维持36~48h。观察2组PCI术后24h支架内血栓形成和出血情况及6~12个月远期疗效。结果观察组24h支架内血栓形成及一般出血发生率均低于对照组,差异均有统计学意义(P<0.05);2组脑出血发生率差异无统计学意义(P>0.05)。观察组患者心绞痛、心肌梗死发生率及病死率均低于对照组,差异均有统计学意义(P<0.05)。结论比伐芦定应用于择期PCI术中可明显改善预后,安全有效,具有推广应用价值。
Objective To observe the clinical effect and safety of bivalirudin in patients undergoing percutaneous coronary intervention (PCI) during coronary heart disease. Methods Fifty patients diagnosed with coronary heart disease were randomly divided into observation group and control group, 25 cases each. Both groups were given aspirin and clopidogrel postoperatively. In the study group, patients in the catheterization room were given 0.75 mg / kg bivalirudin intravenously before PCI as the loading dose, and then were continuously infused at 1.75 mg / (kg · h) until the end of surgery. Patients in the control group received Sheparin injection of unfractionated heparin, continuous intravenous infusion of tirofiban after PCI for 36 ~ 48h. The stent thrombosis and hemorrhage at 24 hours after PCI and the long-term efficacy of 6 to 12 months were observed. Results The rate of stent thrombosis and general bleeding in the observation group was lower than that in the control group (P <0.05). There was no significant difference in the incidence of cerebral hemorrhage between the two groups (P> 0.05). The incidence of angina pectoris, myocardial infarction and mortality in the observation group were lower than those in the control group, with statistical significance (P <0.05). Conclusion Bivalirudin used in elective PCI can significantly improve the prognosis, safe and effective, with the promotion and application value.