替格瑞洛联合比伐卢定对行急诊PCI术的急性冠脉综合征患者疗效观察

摘要

[Objective]To investigate the clinical efficacy and bleeding risk of tigrilol combined with bivalu-dine in patients with acute coronary syndrome (ACS)treated with emergency percutaneous coronary interven-tion (PCI).[Methods]The clinical data of 1 1 6 patients with ACS treated with emergency PCI from November 2016 to November 2017 in Hunan Brain Hospital were retrospectively analyzed and divided into observation group (n=52,administrated with tigrilol before operation and intraoperatively combined with bivaldine)and control group (n =64,administrated with tigrilol before operation intraoperatively combined with common heparin)according to their drug use.Both groups were given aspirin orally before operation.The blood flow grade of thrombolytic test in myocardial infarction was observed during operation,and the clinical effect was observed after operation.Left ventricular ej ection fraction (LVEF)and left ventricular end-diastolic diameter (LVDED)were compared at 7 days after operation.The major cardiovascular events (MACEE)and the inci-dence of hemorrhage were recorded and compared between the two groups.[Results]There was no significant difference in the number of stents implanted by PCI,and the level of LVEDV and LVEF in both groups at 7 days and 1 month after operation (mean P >0.05),and there was no significant difference between the two groups in the proportion of TIMI blood flow grading and sucking thrombus before and after operation (P >0.05).There was no significant difference in the incidence of MACE,acquired thrombocytopenia and stent thrombosis between the two groups 1 month after operation (mean P >0.05),the total incidence of hemor-rhage in the observation group after PCI was lower than that in the control group,and the two groups had slight hemorrhage.The difference was statistically significant(P <0.05).[Conclusion]Tigrilol combined with bivaludine for emergency PCI treatment in ACS patients dose not increase thrombotic events within 30 days and could effectively reduce the incidence of bleeding.%[目的]探讨替格瑞洛联合比伐卢定在急性冠脉综合征(ACS)患者行急诊经皮冠状动脉介入(PCI)治疗中的临床疗效及出血风险.[方法]回顾性分析2016年11月至2017年11月于湖南省脑科医院行急诊PCI术治疗的116例ACS患者的临床资料,根据其使用药物的不同将其分为观察组(n=52,术前给予替格瑞洛,术中联合比伐卢定)和对照组(n=64,术前给予替格瑞洛,术中联合普通肝素).两组患者手术前均同时给予阿司匹林口服.术中观察心肌梗死溶栓试验(TIMI)血流分级,术后观察临床疗效、比较术后7 d、1个月左室射血分数(LVEF)及左室舒张末期内径(LVDED),记录并比较两组患者主要心血管事件(MACE)及出血发生率.[结果]两组PCI植入支架数,术后7 d及1个月LVED、LVEF水平比较,差异均无统计学意义(均P >0.05);两组术前及术后TIMI 血流分级及抽吸血栓所占比例比较,差异无统计学意义(P >0.05).两组术后1个月MACE、获得性血小板减少症及支架内血栓发生率比较,差异均无统计学意义(均P >0.05);PCI术后观察组出血总发生率低于对照组,两组均为轻微出血,差异具有统计学意义(P <0.05).[结论]替格瑞洛联合比伐卢定用于ACS患者急诊PCI治疗中,不增加30 d内血栓事件,并能有效减少出血发生.