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|本期目录/Table of Contents|

比伐芦定在尿激酶溶栓治疗后冠状动脉介入过程中应用的安全性

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2015年第1期
页码:
20-022
栏目:
临床研究
出版日期:
2014-09-25

文章信息/Info

Title:
Safety of bivalirudin in percutaneous coronary intervention following urokinase thrombolytic therapy
作者:
周 贇; 孙育民; 张 雁; 黄少华; 陶文其; 曹 宾; 王 骏
(上海市静安区中心医院心内科，上海 200040)
Author(s):
ZHOU Yun;  SUN Yu-min;  ZHANG Yan;  HUANG Shao-hua;  TAO Wen-qi;  CAO Bin;  WANG Jun
(Department of Cardiology, Central Hospital of Jing’an District, Shanghai 200040, China)
关键词:
心肌梗死; ST段抬高型; 急性; 比伐芦定; 经皮冠状动脉介入; 溶栓; 尿激酶; 出血; 死亡
Keywords:
myocardial infarction;  bivalirudin;  percutaneous coronary intervention;  fibrinolysis;  urokinase;  hemorrhage;  death
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的:初步评价ST段抬高型急性心肌梗死（STEMI）尿激酶溶栓治疗后急诊经皮冠状动脉介入治疗（PCI）过程中应用比伐芦定的安全性。方法： 回顾分析2012年10月~2013年8月于尿激酶溶栓后3~24 h内行急诊PCI治疗过程中应用了比伐芦定16例患者的资料（比伐芦定组），按1∶2匹配选取既往急诊PCI治疗过程中常规应用普通肝素的此类患者资料，按性别、年龄、病变血管相匹配纳入32例患者作为对照组（普通肝素组），分析术后30 d内的主要终点事件（包括全因死亡、再发心肌梗死）以及严重出血性并发症的发生情况。结果： 两组基线资料对比，差异无显著意义。30 d内普通肝素组1例发生主要终点事件及1例严重出血并发症，两组间主要终点事件和严重出血并发症发生率差异无统计学意义。结论： STEMI尿激酶溶栓治疗后行急诊PCI过程中应用比伐芦定相对安全。
Abstract:
AIM:To evaluate the safety of bivalirudin in percutaneous coronary intervention following urokinase thrombolytic therapy. METHODS: Medical records were analyzed in the 16 patients who were given bivalirudin during emergency PCI within 3-24 h of thrombolytic therapy between October 2012 and August 2013 (bivalirudin group). The same type of records were screened where unfractionated heparin (UFH) was used during emergency PCI at a ratio of 1:2 for the control group of 32 patients based on age- and sex-matching and target coronary artery (UFH group). The main endpoint events including all-cause mortality and re-infarction and severe bleeding complications were compared between groups. RESULTS: Comparison of baseline data between groups showed no significant difference. There was one occurrence of endpoint event and one severe bleeding event within 30 days in the UFH group. The difference in the occurrence of main endpoint event and severe bleeding complication between groups was not statistically significant. CONCLUSION: Bivalirudin in percutaneous coronary intervention following urokinase thrombolytic therapy is safe.

参考文献/References

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[2]Mehran R,Lansky AJ,Witzenbichler B,et al.Bivalirudin in patients under-going primary angioplasty for acute myocardial infarction(HORIZONS-AMI):1-year results of a randomised controlled trial[J].Lancet,2009,374(9696):1149-1159.
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[4]Lincoff AM,Kleiman NS,Kereiakes DJ,et al.Long-term efficacy of bivalirudin and provisional glycoprotein IIb/IIIa block-ade vs heparin and planned glycoprotein IIb/IIIa blockade dur-ing percutaneous coronary revascularization: REPLACE-2 randomized trial[J].JAMA,2004,292(6):696-703.
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备注/Memo

备注/Memo:
收稿日期：2014-02-26.
基金项目：上海市静安区重点学科项目资助（JWXK201201）
通讯作者：王骏,主任医师，主要从事冠心病和心律失常介入治疗研究Email：wangjun@medmail.com.cn
作者简介：周贇，主治医师Email:zhouyun2326@hotmail.com
更新日期/Last Update: 2015-01-20