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目的比较比伐卢定与替罗非班合用肝素在急诊经皮冠状动脉介入治疗(PCI)中的临床疗效。方法选取2012年2月—2015年6月南昌大学第一附属医院收治的220例急性ST段抬高型心肌梗死患者,均于发病12h内行急诊PCI术,随机分为研究组和对照组,各110例。对照组术前及术中给予替罗非班和普通肝素静脉滴注,研究组给予比伐卢定治疗,综合比较两组术后90min ST段回降百分比、心肌梗死溶栓治疗临床试验(TIMI)血流分级及出血发生率。结果两组患者术后90min心电图ST段回降百分比、TIMI血流分级比较,差异无统计学意义(P>0.05)。两组患者术后均无脑出血发生,研究组消化道出血、咯血发生率低于对照组,差异有统计学意义(P<0.05)。结论比伐卢定与替罗非班合用肝素在急诊PCI治疗中疗效相近,比伐卢定不良反应发生率低。
Objective To compare the clinical efficacy of bivalirudin and tirofiban combined with heparin in emergency percutaneous coronary intervention (PCI). Methods From February 2012 to June 2015, 220 patients with acute ST-elevation myocardial infarction admitted to the First Affiliated Hospital of Nanchang University were enrolled in the study. The patients were randomly divided into study group and control group 110 cases. The control group was treated with intravenous infusion of tirofiban and unfractionated heparin preoperatively and intraoperatively. The study group was given bivalirudin, and the percentage of ST segment regression in 90 min after the operation was compared. The clinical trial of thrombolysis in myocardial infarction (TIMI Blood flow classification and bleeding incidence. Results There was no significant difference between the two groups in the percent of ST segment regression at 90 min after electrocardiogram and TIMI grade at 90 min after operation (P> 0.05). No postoperative cerebral hemorrhage occurred in both groups. The incidence of gastrointestinal bleeding and hemoptysis in the study group was lower than that in the control group (P <0.05). Conclusion The efficacy of bivalirudin and tirofiban combined with heparin in the treatment of emergency PCI is similar, and the incidence of adverse reactions of bivalirudin is low.