磺达肝癸钠对急性冠脉综合征患者纤溶系统和内皮细胞功能的影响

摘要

Objective To observe the effect and security of fondaparinux Na on fibrinolysis system and vascular endothelial function of patients with acute coronary syndrome. Methods 80 patients with ACS were selected and randomly divided into the treatment group and the control group,40 cases in each group. On the basis of basic treatment,the treatment group was given Fondaparinux Na,and the control group was given low-molecular-weight heparins. After 7 days treatment,the clinical effect,t-PA,PAI-1,VEGF,ET-1 and adverse reactions were observed. Results After treatment,the total effective rate of the observation group was 85. 00%,which has no significantly difference with 87. 50% of the control group ( P > 0. 05);the expression of t-PA,PAI-1,VEGF,ET-1 in the two groups were significantly improved,and those in the treatment group were significantly better than those of the control group( P < 0. 05);compare with the control group,the incidence of acute myocardium infarction and hemorrhea significantly lower than those of the control group ( P < 0. 05). Conclusion Fondaparinux Na in the treatment of ACS has same effective with low-molecular-weight heparins, and has good safe. the bleeding point line was reduced while it has effective anticoagulant,it is in favor of the healing of the pa-tients. At the same time,the fondaparinux Na has good effect on fibrinolysis system and vascular endothelial function of patients with ACS,it can promote the recovery and reach the therapeutic aim,which is worthy of clinical promotion.%目的：观察磺达肝癸钠对急性冠脉综合征（ACS）患者纤溶系统和内皮细胞功能的影响。方法将80例ACS患者随机分为治疗组和对照组，各40例。治疗组予临床基础用药+磺达肝癸钠，对照组予临床基础用药+低分子肝素，连用7 d。观察临床疗效、人组织纤溶酶原激活物（t－PA）、人纤溶酶原激活剂抑制物（PAI－1）、血管内皮生长因子（VEGF）；放射免疫法测定血浆血管内皮素－1（ET－1）表达水平及心脏事件和不良反应。结果治疗后，治疗组总有效率为85.00%，对照组为87.50%，两组相比无统计学差异（ P＞0.05）；两组t－PA、PAI－1、VEGF、ET－1表达水平均有显著改善，且治疗组变化幅度更明显( P＜0.05)与对照组比较，治疗组急性心肌梗死、大出血发病率显著低于对照组（ P＜0.05）。结论磺达肝癸钠治疗ACS，临床疗效与低分子肝素相当，且安全性更高。在有效抗凝的同时可明显降低出血事件，更利于患者的愈后与康复。同时，磺达肝癸钠对ACS患者异常的纤溶系统和失调的内皮细胞功能产生影响，促进恢复，达到治疗目的，值得临床推广。