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目的观察比伐卢定在急性ST段抬高型心肌梗死(ASTEMI)患者急诊经皮冠状动脉介入治疗(PCI)术中的抗凝效果。方法选取2014—2015年山东大学齐鲁医院收治的ASTEMI患者96例,均行急诊PCI术,采用随机数字表法分为对照组和观察组,每组48例。对照组患者急诊PCI术中采用普通肝素进行抗凝治疗,观察组患者采用比伐卢定进行抗凝治疗。比较两组患者主要心血管不良事件(MACE)、出血事件发生率及治疗前后左心室射血分数(LVEF)、B型脑钠肽(BNP)。结果两组患者MACE发生率比较,差异无统计学意义(P>0.05);观察组患者出血事件发生率低于对照组(P<0.05)。两组患者治疗前LVEF、BNP比较,差异无统计学意义(P>0.05);观察组患者治疗后LVEF高于对照组,BNP低于对照组(P<0.05)。结论比伐卢定在ASTEMI患者急诊PCI术中的抗凝效果与普通肝素相当,但安全性较高。
Objective To observe the anticoagulant effect of bivalirudin in patients with acute ST-segment elevation myocardial infarction (ASTEMI) undergoing percutaneous coronary intervention (PCI). Methods Ninety-six patients with ASTEMI admitted to Qilu Hospital of Shandong University from 2014 to 2015 were enrolled in this study. All patients underwent emergency PCI and were divided into control group and observation group by random number table. Patients in the control group underwent emergency PCI with unfractionated heparin for anticoagulation and patients in the observation group received anticoagulant therapy with bivalirudin. The main cardiovascular adverse events (MACE), the incidence of bleeding events and the left ventricular ejection fraction (LVEF) and BNP in both groups were compared. Results There was no significant difference in the incidence of MACE between the two groups (P> 0.05). The incidence of bleeding in the observation group was lower than that of the control group (P <0.05). There was no significant difference in LVEF and BNP between the two groups before treatment (P> 0.05). The LVEF in the observation group was higher than that in the control group and BNP was lower than the control group (P <0.05). Conclusion The anticoagulant effect of bivalirudin in patients with ASTEMI in emergency PCI is comparable to that of unfractionated heparin, but it is safe.