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|本期目录/Table of Contents|

IABP辅助的患者应用磺达肝葵钠抗凝对下肢缺血的影响

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2014年第1期
页码:
64-66069
栏目:
临床研究
出版日期:
2013-12-02

文章信息/Info

Title:
Effect of anticoagulant therapy with fondaparinux sodium on limb ischemia in patients treated with intra-aortic balloon counterpulsation
作者:
李 彪; 吴同果; 赵 强; 罗景云 ; 徐 念; 韦建瑞
(暨南大学第四附属医院、广州市红十字会医院心血管内科,广东 广州 510220)
Author(s):
LI Biao;  WU Tong-guo;  ZHAO Qiang;  LUO Jing-yun;  XU Nian;  WEI Jian-rui
(Department of Cardiology, Red Cross Hospital of Guangzhou City & Fourth Affiliated Hospital of Jinan University, Guangzhou 510220, Guangdong, China)
关键词:
主动脉内球囊反搏; 磺达肝葵钠; 并发症
Keywords:
fondaparinux sodium;  cardiogenic shock;  intra-aortic balloon counterpulsation
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的:观察磺达肝葵钠在应用主动脉内球囊反搏（Intra-aortic balloon counterpulsation，IABP）辅助的患者中抗凝治疗对下肢缺血的影响。方法:将76例确诊为急性心肌梗死（AMI）伴有心源性休克（cardiogenic shock，CS）的患者,急诊经皮冠状动脉介入（PCI）术后应用IABP辅助治疗，随机分为两组：试药组(n=39)：磺达肝葵钠针剂，2.5 mg皮下注射,1次/d， 抗凝治疗5～7 d；对照组(n=37)：依诺肝素针剂4 000 U,皮下注射1次/12 h，治疗5～7 d。检测两组即刻、拔除IABP后血小板计数（PLT），活化部分凝血活酶时间（APTT），国际标准化比值（INR），彩色多普勒超声检查双下肢动脉血流，观察IABP表面血栓的情况，临床出血事件。结果:两组一般肢体缺血事件无显著性差异；试药组APTT延长及出血并发症发生率较对照组显著减少(P<0.01)。结论:应用IABP辅助的AMI伴CS患者用磺达肝葵钠抗凝治疗预防下肢动脉缺血效果好，出血并发症少。
Abstract:
AIM:To evaluate the effect of anticoagulant therapy with fondaparinux sodium on limb ischemia in patients treated with intra-aortic balloon counterpulsation (IABP). METHODS: Seventy-six patients, who were diagnosed with acute myocardial infarction (AMI) associated with cardiogenic shock (CS) and were treated with post-percutaneous coronary intervention (PCI) supported by IABP, were randomly divided into two groups. In group A, 39 patients were given the basic treatment and anticoagulant therapy of fondaparinux sodium pin 2.5 mg subcutaneously Qd for 5-7 days and in group B, 37 patients were given the basic treatment and anticoagulant therapy of enoxaparin 4 000 units of subcutaneously injected Q12h for 5-7 days. IABP application time for the two groups was 12 h-10 d. Platelets (PLT), activated partial thromboplastin time (APTT) and international normalized ratio were tested in the two groups at instantly and after removal of IABP. Lower extremities arterial blood flow was measured by color B-mode ultrasound and thrombosis on IABP surface and clinical bleeding events were observed and recorded. RESULTS: No significant difference in events of limb ischemia was observed between the two groups, and no arterial embolization necrosis in the lower extremity and no thrombosis on the IABP catheter surface were found. Cases with extended APTT in group A were significantly fewer than those in group B (P<0.01). Bleeding complications in group A were also significantly fewer than those in group B (P<0.01). CONCLUSION: Anticoagulant therapy with fondaparinux sodium achieves good effect as enoxaparinon on limb ischemia in patients with AMI accompanied with CS supported by IABP but causes fewer bleeding complications.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2013-06-15.通讯作者：吴同果，主任医师，主要从事冠心病和心律失常研究 Email：wutongguo@medmail.com.cn 作者简介：李彪，主治医师，硕士 Email:libiao2025@163. com
更新日期/Last Update: 2014-01-20