比伐卢定对IABP辅助下急性心肌梗死行PCI患者的疗效及血小板数量的影响

Influence of bivalirudin on efficacy and platelet count in AMI patients after PCI assisted with intra-aortic balloon pump

摘要:

目的 评价比伐卢定对主动脉内球囊反搏术（IABP）辅助下急性心肌梗死（AMI）患者行经皮冠状动脉介入治疗（PCI）的疗效及安全性。方法 回顾性分析了2013年1月至2015年9月于沈阳军区总医院接受IABP联合PCI治疗的AMI患者92例，依据术中抗凝药的使用情况，分为两组：比伐卢定组（n＝30）和肝素组（n＝62）。观察指标为PCI围术期出血和主要心脏不良事件（MACE）发生率。结果 比伐卢定组患者住院期间出血事件发生率较肝素组低，但差异无统计学意义。比伐卢定组血小板下降幅度显著低于肝素组（P＝0.002）。随访期间两组患者MACE发生率差异无统计学意义（P＞0.05）。结论 PCI术中应用比伐卢定抗凝对IABP辅助的AMI患者是安全有效的，且对血小板数量影响较小。

Abstract:

Objective To evaluate the efficacy and safety of thrombin inhibitor, bivalirudin, in the patients with acute myocardial infarction (AMI) undergoing intra-aortic balloon pump (IABP) assisted percutaneous coronary intervention (PCI). Methods A retrospective study was performed on 92 AMI patients who received IABP-assisted PCI in our department from Jan 2013 to Sep 2015. Based on the anticoagulant therapy during perioperative period, the patients were assigned into bivalirudin group (n＝30) and heparin group (n＝62). The incidences of peri-operative bleeding and major adverse cardiac events (MACE) were compared between the 2 groups. Results The bivalirudin group had a lower rate of in-hospital bleeding, but without significant difference with the heparin group. However, the decline of platelet count after PCI was significantly lower in the bivalirudin group than in the heparin group (P＝0.002). In the follow-up period, there was no obvious difference in the incidence of MACE between 2 groups (P＞0.05). Conclusion Bivalirudin is effective and safe, and has mild effect on platelet count in AMI patients undergoing IABP-assisted PCI.