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中国人民解放军总医院
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中国人民解放军总医院老年心血管病研究所
中国科技出版传媒股份有限公司
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中华老年多器官疾病杂志编辑委员会
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创刊人 王士雯
总编辑 范利
副总编辑 陈韵岱
执行主编 叶大训
编辑部主任 王雪萍
ISSN 1671-5403
CN 11-4786
创刊时间 2002年
出版周期 月刊
邮发代号 82-408
友情链接
刘少文,兰为群,郑娟娟,胡磊,舒逸,刘如泉,胡家顺.比伐芦定用于急性冠状动脉综合征合并慢性肾脏疾病4期患者经皮冠状动脉介入治疗术中抗凝疗效与安全性的评价[J].中华老年多器官疾病杂志,2021,20(4):290~294
比伐芦定用于急性冠状动脉综合征合并慢性肾脏疾病4期患者经皮冠状动脉介入治疗术中抗凝疗效与安全性的评价
Evaluation of anticoagulant efficacy and safety of bivalirudin in treatment of acute coronary syndrome with stage 4 chronic kidney disease during percutaneous coronary intervention
投稿时间:2020-07-06  
DOI:10.11915/j.issn.1671-5403.2021.04.060
中文关键词:  急性冠脉综合征;慢性肾脏疾病;比伐芦定
英文关键词:acute coronary syndrome; chronic kidney disease; bivalirudin Corresponding author:HU Jia-Shun, E-mail:13707192707@139.com〖FL
基金项目:
作者单位E-mail
刘少文 武汉市汉口医院心血管内科,武汉430012 13707192707@139.comevaluation 
兰为群 武汉市汉口医院心血管内科,武汉430012 13707192707@139.comevaluation 
郑娟娟 武汉市汉口医院心血管内科,武汉430012 13707192707@139.comevaluation 
胡磊 武汉市汉口医院心血管内科,武汉430012 13707192707@139.comevaluation 
舒逸 武汉市汉口医院心血管内科,武汉430012 13707192707@139.comevaluation 
刘如泉 武汉市汉口医院心血管内科,武汉430012 13707192707@139.comevaluation 
胡家顺 武汉市汉口医院心血管内科,武汉430012 13707192707@139.comevaluation 
摘要点击次数: 37
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中文摘要:
      目的 评价比伐芦定用于急性冠状动脉综合征(ACS)合并慢性肾脏疾病(CKD)4期患者经皮冠状动脉介入治疗术(PCI)中抗凝疗效与安全性。方法 回顾性分析2017年4月至2019年10月在武汉市汉口医院接受PCI治疗的39例ACS合并CKD 2~4期患者的临床资料,根据CKD临床分期标准分为对照组(CKD 2~3期)和观察组(CKD 4期)。比较2组患者围手术期活化凝血时间(ACT),术后24h活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、凝血酶原时间(PT),术后30d出血情况及主要不良心脑血管事件(MACCE)。采用SPSS 20.0 统计软件对数据进行分析。组间比较采用t检验或χ2检验。结果 对照组和观察组给药后10min ACT值[(438.38±76.79) 和(413.61±66.49)s]、术后即刻ACT值[(457.38±73.13)和(425.28±60.96)s]及停药后2h ACT值[(184.21±48.15)和(171.39±38.86)s]比较,差异均无统计学意义(均P>0.05)。对照组和观察组术后24h APTT[(37.67±5.51)和(39.50±9.04)s]、 TT[(37.52±8.21)和(38.44±7.04)s]及PT[(14.76±3.13)和(15.00±3.01)s]比较,差异均无统计学意义(均P>0.05)。30d随访结果显示,对照组和观察组出血学术研究会(BARC) 1型出血事件发生率[14.29%(3/21)和11.11%(2/18)]及BARC 2型出血事件发生率[4.76%(1/21)和5.56%(1/18)]比较,差异均无统计学意义(均P>0.05),均未发生BRAC 3~5型出血事件。对照组和观察组MACCE发生率[9.52%(2/21)和11.11%(2/18)]比较,差异无统计学意义(P>0.05)。结论 比伐芦定用于ACS合并CKD4期患者PCI术中抗凝具有较好的疗效及安全性。
英文摘要:
      Objective To evaluate the anticoagulant efficacy and safety of bivalirudin in patients with acute coronary syndrome (ACS) and stage 4 chronic kidney disease (CKD) during percutaneous coronary intervention (PCI). Methods A retrospective analysis was made of the clinical data of 39 ACS patients with CKD stages 2 to 4 who underwent PCI in Hankou Hospital of Wuhan from April 2017 to October 2019. The patients were divided into control group (CKD stages 2 to 3) and observation group (CKD stage 4) according to the CKD clinical staging criteria. The two groups were compared for the activated clotting time (ACT) in the perioperative period, activated partial thromboplastin time (APTT), thrombin time (TT) and prothrombin time (PT) at 24 h after operation, bleeding at 30 d after operation, and major adverse cardiac and cerebrovascular events (MACCE). Data were analyzed using SPSS statistics 20.0. Comparisons between groups were performed using t tests orχ2 tests. Results There were no significant differences between the control and observation groups in ACT at 10 min after drug administration[(438.38±76.79) vs (413.61±66.49) s], at immediate postoperative period [(457.38±73.13) vs (425.28±60.96) s], and at 2 h after drug withdrawal [(184.21±48.15) vs (171.39±38.86) s] (P>0.05 for all). Control and observation groups did not have significant differences in APTT [(37.67±5.51) vs (39.50±9.04) s], TT [(37.52±8.21) vs (38.44±7.04) s], and PT [(14.76±3.13) vs (15.00±3.01) s] at 24 h postoperatively (P>0.05 for all). At 30-d follow-up, there was no significant difference between control and observation groups in the incidence of BARC type 1 bleeding events [14.29% (3/21) vs 11.11% (2/18)] and BARC type 2 bleeding events [4.76% (1/21) vs 5.56% (1/18)] (P>0.05 for both), and no patients had a BARC type 3 to 5 bleeding event. There was no significant difference between the two groups in the incidence of MACCE [9.52% (2/21) vs 11.11% (2/18)] (P>0.05). Conclusion Bivalirudin had good efficacy and safety in anticoagulation in patients with ACS and CKD4 during PCI.
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