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目的 对比比伐卢定和普通肝素应用于肾功能不全患者的冠状动脉介入(PCI)术中患者的凝血功能及安全性,并分析其临床意义.方法 选择2014年6月-2016年6月在解放军总医院行PCI手术的肾功能不全的患者共166例,按照使用药物不同,将其分为对照组和观察组,对照组患者使用普通肝素注射抗凝,而观察组患者采用比伐卢定注射抗凝.观察两组患者在用药前、术后即刻、术后2h的激活凝血时间(ACT).结果 术后即刻两组无明显差异,术后2h两组患者的ACT均明显下降,但是比伐卢定组的下降程度更大,差异具有统计学意义(P＜0.05).术后出血事件比伐卢定组明显低于肝素组.结论 比伐卢定相比于普通肝素,应用于行PCI手术的肾功能不全的患者效果显著,半衰期更短,且患者术后出血情况较少.“,”Objective To compare the application of bivalirudin and unfractionated heparin in the percutaneous coronary intervention (PCI) for patients with renal inadequacy and analyzetheir clinical significance.Methods A total of 166 patients were prepare to PCI with renal dysfunction were divided into the control group and the observation group from June 2014 to June 2016 in our hospital.The patients of control group were given/Injected unfractionated heparin injection for anticoagulation and the observation group used bivalirudin for anticoagulation.The activated clotting time (ACT) 5 minutes before medication,right after surgery,and 2 hours after of the two groups were observed.Results There are no statistically significant differences in ACT at right after surgery,but 2 hours after drug withdrawal,ACT of both groups decreased significantly and the decreasing degree of the bivalirudin group was larger,with statistically differences (P ＜0.05).Conclusion In the PCI patients with renal dysfunction,bivalirudin has more significant effects,shorter half-life period and less postoperative bleeding than unfractionated heparin.