比伐卢定对急诊经皮冠状动脉介入患者心功能的影响

发布时间：2018-12-11 23:50

【摘要】：目的探讨比伐卢定对急诊行经皮冠状动脉介入(PCI)治疗患者术后心功能的影响。方法选取行急诊PCI治疗的急性ST段抬高型心肌梗死(STEMI)患者116例,随机分为比伐卢定组(比伐卢定+PCI)59例和对照组(普通肝素+PCI)57例。比较两组患者PCI术后梗死相关动脉TIMI血流分级,90 min心电图ST段回落百分比(sum-STR);术后12 h及7、30 d血清N末端脑钠肽前体(NT-proBNP)水平,左室舒张末期内径(LVEDd)、左室射血分数(LVEF)变化,并观察术后30 d内主要心脏不良事件(MACE,心绞痛发作、再次心肌梗死、急性心衰、心源性猝死)和出血的发生率。结果两组患者急诊PCI术后TIMI 3级血流比例,术后12 h血清NT-proBNP水平及超声心动图LVEDd、LVEF相比,差异无统计学意义(P0.05);术后90 min心电图回落百分比,7、30 d血清NT-proBNP水平及LVEDd、LVEF比较,差异均有统计学意义(P0.05),且比伐卢定组术后30 d内MACE和出血的发生率明显低于对照组(P0.01)。结论比伐卢定能明显改善急诊PCI患者术后心功能,并减少MACE及出血的发生率。
[Abstract]:Objective to investigate the effect of bivaludine on cardiac function after percutaneous coronary intervention (PCI) in emergency patients. Methods 116 patients with acute ST segment elevation myocardial infarction (STEMI) who were treated with emergency PCI were randomly divided into two groups: Bivaludine group (59 cases) and normal heparin PCI group (57 cases). The TIMI blood flow grade of infarct-related artery and the percentage of ST segment fall (sum-STR) of 90 min electrocardiogram (ECG) were compared between the two groups after PCI. Serum levels of N-terminal brain natriuretic peptide precursor (NT-proBNP) and left ventricular end-diastolic diameter (LVEDd),) left ventricular ejection fraction (LVEF) were measured at 12 and 7 days after operation. The main adverse cardiac events (MACE, angina pectoris) were observed 30 days after operation. Incidence of secondary myocardial infarction, acute heart failure, sudden cardiac death) and bleeding. Results there was no significant difference in the ratio of TIMI grade 3 blood flow, serum NT-proBNP level and echocardiographic LVEDd,LVEF between the two groups after emergency PCI (P0.05). The percentage of electrocardiogram decreased at 90 min, the level of serum NT-proBNP and LVEDd,LVEF were significantly higher than those of control group (P0.05), and the incidence of MACE and bleeding in 30 days after operation was significantly lower than that in control group (P0.01). Conclusion Bivaludine can significantly improve the cardiac function and reduce the incidence of MACE and bleeding in emergency patients with PCI.
【作者单位】：滨州医学院附属医院;
【分类号】：R542.22

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