[1]杨 鲲,何 勇△,孙 静.比伐卢定与普通肝素对冠心病合并2型糖尿病患者经皮冠状动脉介入术凝血功能的影响研究*[J].陕西医学杂志,2020,49(9):1157-1160.[doi:DOI:10.3969/j.issn.1000-7377.2020.09.026]
　YANG Kun,HE Yong,SUN Jing..Effect of bivalirudin and unfractionated heparin on coagulation function in patients with coronary heart disease complicated with type 2 diabetes mellitus undergoing PCI[J].,2020,49(9):1157-1160.[doi:DOI:10.3969/j.issn.1000-7377.2020.09.026]
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比伐卢定与普通肝素对冠心病合并2型糖尿病患者经皮冠状动脉介入术凝血功能的影响研究*
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
49
期数:
2020年9期
页码:
1157-1160
栏目:
药物与临床
出版日期:
2020-09-01

文章信息/Info

Title:
Effect of bivalirudin and unfractionated heparin on coagulation function in patients with coronary heart disease complicated with type 2 diabetes mellitus undergoing PCI
作者:
杨 鲲1; 何 勇2△; 孙 静1
1.武警陕西省总队医院心内科(西安 710054); 2.武警陕西省总队医院心外科(西安 710054)
Author(s):
YANG Kun; HE Yong; SUN Jing.
Department of Cardiology,Shaanxi Provincial Armed Police Corps Hospital(Xi'an 710054)
关键词:
比伐卢定;  普通肝素;  糖尿病;  PCI术;  凝血功能;  主要心血管不良事件
Keywords:
Bivalirudin;  Unfractionated heparin;  Diabetes mellitus;  Percutaneous coronary intervention;  Coagulation function;  MACE
分类号:
R541.4
DOI:
DOI:10.3969/j.issn.1000-7377.2020.09.026
文献标志码:
A
摘要:
目的:探讨比伐卢定与普通肝素对冠心病合并2型糖尿病患者经皮冠状动脉介入术(PCI)凝血功能的影响。方法:收集冠心病合并2型糖尿病患者150例,随机分为对照组与研究组,每组75例。对照组予以普通肝素治疗,研究组予以比伐卢定治疗,比较两组患者凝血功能指标、血清脑利钠肽(BNP)水平、微循环阻力指数(IMR)、出血情况以及主要心血管不良事件(MACE)发生率。结果:两组术后1 h,PT、APTT显著升高(P<0.05),但两组比较差异无统计学意义(P>0.05); 研究组GMP-140显著降低(P<0.05),对照组GMP-140显著升高(P<0.05),两组比较有统计学差异(P<0.05); 研究组BNP显著低于对照组,差异有统计学意义(P<0.05); 两组IMR显著降低(P<0.05),但两组比较差异无统计学意义(P>0.05)。在住院期间,研究组出血情况与对照组相比较轻微,但两组比较差异无统计学意义(P>0.05)。术后3个月,研究组MACE发生率与对照组比较,差异无统计学意义(P>0.05)。结论:比伐卢定与普通肝素治疗冠心病合并2型糖尿病均具有较好的抗凝效果,可改善患者微循环。与普通肝素相比,比伐卢定在抑制血小板活化和降低BNP水平方面具有优势。
Abstract:
Objective:To explore the effect of bivalirudin and unfractionated heparin on coagulation functionin in patients with coronary heart disease complicated with type 2 diabetes mellitus undergoing PCI.Methods:A total of 150 patients with coronary heart disease complicated with type 2 diabetes mellitus were collected and randomly divided into control group and study group,75 cases each.The control group was treated with unfractionated heparin,and the study group was treated with bivalirudin.The indexes of coagulation function,serum brain natriuretic peptide(BNP)level,index of microcirculation resistance(IMR),bleeding and incidence rate of major adverse cardiovascular events(MACE)were compared between the two groups.Results:At 1 hour after operation,the PT and APTT were significantly increased in the two groups(P<0.05),but there were no statistical difference between the two groups(P>0.05); the level of GMP-140 in the study group was significantly decreased(P<0.05),while that in the control group was significantly increased(P<0.05),and there was statistical difference between the two groups(P<0.05); the level of BNP in the study group was lower than that in the control group(P<0.05); the IMR values in the two groups were significantly decreased(P<0.05),but there was no statistical difference between the two groups(P>0.05).The bleeding in the study group during hospitalization was milder compared with that in the control group,but there was no statistical difference between the two groups(P>0.05).At 3 months after operation,there was no statistical difference in the incidence rate of MACE between the two groups(P>0.05).Conclusion:Bivalirudin and unfractionated heparin have better anticoagulant effect and can improve microcirculation in patients with coronary heart disease complicated with type 2 diabetes mellitus.Compared with unfractionated heparin,bivalirudin has an advantage in inhibiting platelet activation and reducing BNP level.

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备注/Memo

备注/Memo:
*陕西省卫生科研基金资助项目(2019E6)
更新日期/Last Update: 2020-09-02