急性冠脉综合征经皮冠状动脉介入治疗术后继发Ⅱ型血小板减少症给予磺达肝癸钠的临床综合效果分析

摘要

Objective To study the effects of acute coronary comprehensive syndrome with PCI therapy after secondary HIT-Ⅱ give sulphur of liver fondaparinux therapy clinical comprehensive effect.MethodsDecimation in 66 patients with acute coronary syndrome after PCI patients was applied on the basis of drug therapy and postoperative anticoagulation.Study group (33 cases) in the postoperative secondary HIT Ⅱ after being diagnosed with stop heparin and give sulphur of fondaparinux, bleeding in the coagulation indexes, within 30 days event and 6months heart vascular pieces efficacy evaluation.ResultsThe use of heparin before.The index of blood coagulation in study group were normal, confirmed HIT Ⅱ when the index change significantly (P<0.05) and the discontinuation of heparin 24h, 3d, 7d indexes compared at diagnosis were restored (P<0.05) and 14 days of heparin to stop with the use of heparin levels.The patients in the study group, the incidence of bleeding events was 9.1%, compared to 15.2% in the control group no significant difference.The patients in the study group of adverse cardiovascular events occurred rate was 12.1%, compared to 18.2% in the control group no significant difference.ConclusionAcute coronary syndrome after PCI HIT-Ⅱ to grant the sulphur of fondaparinux treatment had no significant effect on blood coagulation function and safety.%目的 研究急性冠脉综合征行经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI) 术后继发肝素诱导的血小板减少症Ⅱ型给予磺达肝癸钠治疗的临床综合效果.方法 抽选66例急性冠脉综合征经PCI术治疗患者均应用基础药物治疗并给予术后抗凝,研究组33例在术后继发Ⅱ型血小板减少症(heparin-induced thrombocytopenia, HIT-Ⅱ)在确诊后即停肝素并给予磺达肝癸钠,以凝血指标、30d内出血事件以及6个月内心血管事件评析疗效. 结果 使用肝素前,研究组凝血指标均正常,确诊HIT-Ⅱ时各指标明显变化(P<0.05),在停用肝素24h、3d、7d时各指标相比于确诊时均明显恢复(P<0.05),停肝素14d时与使用肝素前水平相当,差异无统计学意义;研究组患者的出血事件发生率为9.1%,与对照组15.2%比较差异无统计学意义;研究组患者的不良心血管事件发生率为12.1%,于对照组18.2%比较差异无统计学意义.结论 急性冠脉综合征行PCI术后继发Ⅱ型血小板减少症给予磺达肝癸钠治疗对凝血功能无明显影响,安全性好.