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摘要:目的探讨老年急性冠状动脉综合征(ACS)患者PCI术后如何应用普通肝素(UFH)抗凝。方法选择接受PCI的老年ACS患者100例。所有患者采用静脉UFH抗凝至少24 h,并随机分为试验组(50倒)和对照组(50例)。试验组按预先设定的UFH标准化抗凝方案调节剂量,对照组由值班医师凭经验调整剂量。以活化部分凝血活酶时间(APTT)45～75 s作为UFH抗凝治疗范围。结果试验组和对照组分别测量APTT 328次和351次,两组抗凝达标比例分别为80.2%和47.3%(P<0.01)。试验组达到治疗范围的平均时间明显小于对照组[(2.9±3.4)h vs (7.6±3.4)h,P<0.01];试验组24 h维持在治疗范围内的平均时间明显大于对照组[(16.9±3.5)h vs(11.6±4.1)h,P<0.01]。结论 UFH标准化抗凝方案可以安全有效地应用于老年ACS患者PCI术后抗凝。
Abstract: Objective To investigate the effect of unfractionated heparin (UFH) anticoagulation after PCI in elderly patients with acute coronary syndrome (ACS). Methods One hundred elderly patients with PCI undergoing PCI were enrolled. All patients received intravenous UFH anticoagulation for at least 24 hours and were randomly divided into experimental group (50 down) and control group (50 cases). The experimental group according to a predetermined UFH standardized anticoagulation regimen dose adjustment, the control group by duty doctor adjusted dose empirically. Activation of partial thromboplastin time (APTT) 45 ~ 75 s as UFH anticoagulant treatment. Results The test group and the control group were measured 328 times and 351 times APTT, the proportion of the two groups were 80.2% and 47.3% (P <0.01). The mean duration of treatment in experimental group was significantly shorter than that in control group [(2.9 ± 3.4) h vs (7.6 ± 3.4) h, P <0.01] 16.9 ± 3.5) h vs (11.6 ± 4.1) h, P <0.01]. Conclusion The standardized UFH anticoagulation scheme can be safely and effectively applied to anticoagulation of elderly patients with ACS after PCI.