[1]曾松柏,曾 山,张 梅,等.老年患者择期冠状动脉介入治疗中低剂量比伐卢定安全性观察[J].介入放射学杂志,2016,(03):250-253.
　ZENG Song- bai,ZENG Shan,ZHANG Mei,et al.The use of low- dose bivalirudin in elderly patients receiving elective percutaneous coronary intervention： observation of its safety[J].journal interventional radiology,2016,(03):250-253.
点击复制

老年患者择期冠状动脉介入治疗中低剂量比伐卢定安全性观察 ()

PDF下载中关闭

分享到：

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2016年03期
页码:
250-253
栏目:
临床研究
出版日期:
2016-03-25

文章信息/Info

Title:
The use of low- dose bivalirudin in elderly patients receiving elective percutaneous coronary intervention： observation of its safety
作者:
曾松柏;  曾 山;  张 梅;  赵 鹏
Author(s):
ZENG Song- bai;  ZENG Shan;  ZHANG Mei;  ZHAO Peng
Cardiac Disease Center， Affiliated Hospital of Armed Police Logiotics Institute， Tianjin 300162， China
关键词:
【关键词】 冠状动脉疾病;  老年人;  经皮冠状动脉介入治疗;  比伐卢定
文献标志码:
A
摘要:
【摘要】 目的 探讨老年患者择期经皮冠状动脉介入治疗（PCI）中应用低剂量比伐卢定的安全性。方法 连续选取年龄＞65岁冠心病患者162例，随机分为标准剂量组（n=80）和低剂量组（n=82）。PCI术前两组患者接受静脉推注负荷剂量比伐卢定0.75 mg/kg，术中标准剂量组以1.75 mg? kg-1?h-1加术后0.2 mg?kg-1?h-1剂量持续给药2 h，低剂量组以1.5 mg?kg-1?h-1加术后0.15 mg?kg-1?h-1剂量持续给药2 h。对比分析两组患者给药后5 min、30 min、手术终止时、术后1 h活化凝血时间（ACT）值以及术后1个月内出血事件、心肌梗死、靶血管重建、支架内血栓、不明原因卒中发生率。结果 低剂量组给药后30 min、手术终止时、术后1 h ACT值与标准剂量组相比均明显降低，分别为（331.2±53.5） s对（383.5±74.7） s、（324.9±47.6） s对（371.3±65.4） s、（289.6±34.9） s对（314.8±43.1） s，P值均＜0.001。两组患者术后1个月内心肌梗死、一般出血事件发生率比较，差异均无统计学意义（P＞0.05），未发生大出血、靶血管重建、支架内血栓和不明原因卒中事件。结论 老年冠心病患者择期PCI术中应用低剂量比伐卢定抗凝，具有良好的治疗效果及安全性

参考文献/References:

［1］ Levine GN, Bates ER, Blankenship JC, et al. 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions［J］. Circulation, 2011, 124: e574- e651.
［2］ Stone GW, Ware JH, Bertrand ME, et al. Antithrombotic strategies in patients with acute coronary syndromes undergoing early invasive management: one- year results from the ACUITY trial［J］. JAMA, 2007, 298: 2497- 2506.
［3］ Kastrati A, Mehilli J, Neumann FJ, et al. Abciximab in patients with acute coronary syndromes undergoing percutaneous coronary intervention after clopidogrel pretreatment: the ISAR- REACT 2 randomized trial［J］. JAMA, 2006, 295: 1531- 1538.
［4］ Schulz S, Mehilli J, Ndrepepa G, et al. Bivalirudin vs. unfractio- nated heparin during percutaneous coronary interventions in patients with stable and unstable angina pectoris: 1- year results of the ISAR- REACT 3 trial［J］. Eur Heart J, 2010, 31: 582- 587.
［5］ Ashby DT, Dangas G, Aymong EA, et al. Relation between the degree of procedural anticoagulation and complications after coronary stent implantation［J］. Am J Cardiol, 2003, 92: 319- 322.
［6］ Ndrepepa G, Berger PB, Mehilli J, et al. Periprocedural bleeding and 1- year outcome after percutaneous coronary interventions: appropriateness of including bleeding as a component of a quadruple end point［J］. J Am Coll Cardiol, 2008, 51: 690- 697.
［7］ Lincoff AM, Kleiman NS, Kereiakes DJ, et al. Long- term efficacy of bivalirudin and provisional glycoprotein Ⅱb/Ⅲa blockade vs heparin and planned glycoprotein Ⅱb/Ⅲa blockade during percutaneous coronary revascularization: REPLACE- 2 randomized trial［J］. JAMA, 2004, 292: 696- 703.
［8］ Kastrati A, Neumann FJ, Mehilli J, et al. Bivalirudin versus unfractionated heparin during percutaneous coronary intervention［J］. N Engl J Med, 2008, 359: 688- 696.
［9］ Cutlip DE, Windecker S, Mehran R, et al. Clinical end points in coronary stent trials: a case for standardized definitions［J］. Circulation, 2007, 115: 2344- 2351.
［10］ 王 珏， 施万印． 抗凝、 抗血小板及溶栓药物的合理应用［J］．介入放射学杂志， 2011， 20： 76- 81．
［11］ Kimmelstiel C, Zhang P, Kapur NK, et al. Bivalirudin is a dual inhibitor of thrombin and collagen- dependent platelet activation in patients undergoing percutaneous coronary intervention［J］. Circ Cardiovasc Interv, 2011, 4: 171- 179.
［12］ Tolleson TR, O’shea JC, Bittl JA, et al. Relationship between heparin anticoagulation and clinical outcomes in coronary stent intervention: observations from the ESPRIT trial［J］. J Am Coll Cardiol, 2003, 41: 386- 393.
［13］ Stabile E, Nammas W, Salemme L, et al. The CIAO （coronary interventions antiplatelet- based only） study: a randomized study comparing standard anticoagulation regimen to absence of anticoagulation for elective percutaneous coronary intervention［J］. J Am Coll Cardiol, 2008, 52: 1293- 1298.
［14］ Lee MS, Oyama J, Iqbal Z, et al. Low- dose heparin for elective percutaneous coronary intervention［J］. J Interv Cardiol, 2014, 27: 58- 62.
［15］ 张 慧， 郑晓群． 比伐卢定在急性冠状动脉综合征中的应用进展［J］． 心血管病学进展， 2015， 36： 352- 355．
［16］ 向定成， 顾晓龙， 潘春梅， 等． 国产比伐卢定用于冠状动脉介入治疗术中抗凝的疗效和安全性评价［J］． 中国循环杂志， 2011， 26： 331- 334．

相似文献/References:

[1]王 红. 紫杉醇涂层球囊治疗冠脉支架术后再狭窄的现状[J].介入放射学杂志,2012,(07):614.
　WANG Hong. The use of paclitaxel- coated balloon in the treatment of coronary in- stent restenosis： its current situation[J].journal interventional radiology,2012,(03):614.
[2]丁雪燕,刘夙璇,秦永文.冠状动脉西罗莫司洗脱支架植入术后晚期及超晚期支架内血栓形成的临床研究[J].介入放射学杂志,2012,(12):1023.
　DING Xue? yan,LIU Su? xuan,QIN Yong? wen..Late and extremely?蛳 late in?蛳 stent thrombosis formation after sirolimus?蛳 eluting stent implantation in coronary artery： a clinical study [J].journal interventional radiology,2012,(03):1023.
[3]吴志勇,关瑞锦,陈诗泉,等. 应用小直径旋磨头联合药物洗脱支架治疗冠状动脉重度钙化病变的疗效[J].介入放射学杂志,2014,(03):198.
　WU Zhi? yong,GUAN Rui? jin,CHEN Shi? quan,et al. Rotational atherectomy using small burr combined with drug-eluting stent implantation for the treatment of heavily calcified coronary lesions： analysis of clinical outcomes[J].journal interventional radiology,2014,(03):198.
[4]杜发旺.冠状动脉支架内血栓形成患者的危险因素及预后[J].介入放射学杂志,2016,(02):160.
　DU Fa- wang.Risk factors and prognosis of patients with coronary stent thrombosis [J].journal interventional radiology,2016,(03):160.

备注/Memo

备注/Memo:
（收稿日期：２０１5-０6-27）
（本文编辑：边 佶）
更新日期/Last Update: 2016-03-22