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目的:回顾性比较冠心病患者接受经皮冠脉介入(PCI)治疗时分别使用低分子量肝素(LMWH)和普通肝素(UFH)的疗效和安全性的差异。方法:选择本院2011-01至2012-12接受PCI术患者共200例,根据PCI使用肝素不同分为LMWH组(n=117),UFH组(n=83)。按常规方法,完成PCI术后,根据患者术中靶血管TIMI血流评价各组疗效,根据术中、后72h内出血/血肿、死亡、其他(心包填塞、胸痛、心源性休克、心脏破裂、室间隔穿孔、室速室颤、心脏骤停,阿斯发作、亚急性支架内血栓形成等)不良事件的发生率,比较各组安全性。结果:(1)各组患者临床基线资料差异无统计学意义(P>0.05)。(2)各组患者PCI术中支架植入后靶血管血流改变存在统计学差异(P<0.05),LMWH在疗效上优于UFH。(3)各组间死亡发生上无统计学差异(P>0.05),在出血/血肿及其他(心包填塞、胸痛、心源性休克、心脏破裂、室间隔穿孔、室速室颤、心脏骤停,阿斯发作、亚急性支架内血栓形成等)的发生上存在统计学差异(P<0.05),LMWH的不良反应少,安全性更高。结论:LMWH在PCI术中疗效更为显著,且较UFH不良反应少、安全性高,更适用于PCI术的抗凝治疗。
Objective: To retrospectively compare the efficacy and safety of low molecular weight heparin (LMWH) and unfractionated heparin (UFH) in patients with coronary artery disease undergoing percutaneous coronary intervention (PCI). METHODS: A total of 200 patients undergoing PCI from January 2011 to December 2012 were selected and divided into LMWH group (n = 117) and UFH group (n = 83) according to PCI heparin. According to the conventional method, after the completion of PCI, the curative effect of each group was evaluated according to the target blood vessel TIMI blood flow of the patients. According to the hemorrhage / hematoma within 72 h after operation, death, other (tachycardia, chest pain, cardiogenic shock, Interventricular septum perforation, ventricular fibrillation, cardiac arrest, Aspen onset, subacute stent thrombosis, etc.) incidence of adverse events, compared the safety of each group. Results: (1) There was no significant difference in clinical baseline data between groups (P> 0.05). (2) There was a significant difference in target vessel blood flow after stent implantation in PCI group (P <0.05). LMWH was superior to UFH in efficacy. (3) There was no significant difference in the incidence of death among the groups (P> 0.05). There was no significant difference in the incidence of death between the groups (P> 0.05) Stop, Aspen attack, subacute stent thrombosis, etc.) there is a statistically significant difference (P <0.05), LMWH adverse reactions less safety higher. Conclusion: LMWH is more effective in PCI and less adverse reactions than UFH. It is safe and suitable for anticoagulant therapy of PCI.