低分子肝素与普通肝素对经皮冠脉介入手术的疗效和安全性的比较

目的:回顾性比较冠心病患者接受经皮冠脉介入(PCI)治疗时分别使用低分子量肝素(LMWH)和普通肝素(UFH)的疗效和安全性的差异。方法:选择本院2011-01至2012-12接受PCI术患者共200例,根据PCI使用肝素不同分为LMWH组(n=117),UFH组(n=83)。按常规方法,完成PCI术后,根据患者术中靶血管TIMI血流评价各组疗效,根据术中、后72h内出血/血肿、死亡、其他(心包填塞、胸痛、心源性休克、心脏破裂、室间隔穿孔、室速室颤、心脏骤停,阿斯发作、亚急性支架内血栓形成等)不良事件的发生率,比较各组安全性。结果:(1)各组患者临床基线资料差异无统计学意义(P0.05)。(2)各组患者PCI术中支架植入后靶血管血流改变存在统计学差异(P0.05),LMWH在疗效上优于UFH。(3)各组间死亡发生上无统计学差异(P0.05),在出血/血肿及其他(心包填塞、胸痛、心源性休克、心脏破裂、室间隔穿孔、室速室颤、心脏骤停,阿斯发作、亚急性支架内血栓形成等)的发生上存在统计学差异(P0.05),LMWH的不良反应少,安全性更高。结论:LMWH在PCI术中疗效更为显著,且较UFH不良反应少、安全性高,更适用于PCI术的抗凝治疗。

The Efficacy and Safety of Low Molecular Weight Heparin and Unfarction Heparin were Compared in Patients with Coronary Heart Disease during Percutaneous Coronary Intervention

ABSTRACT Objective: To evaluate the efficacy and safety of low molecular weight heparin and unfarction heparin in patients with coronary heart disease during percutaneous coronary intervention by investigating the MACE beteewn the percutaneous coronary inter- vention procedure and post percutaneous coronary intervention 72 hours. Methods: 200 patients with coronary heart disease who accepted percutaneous coronary intervention were investigated in this study. According to the anticoagulants, these patients were divided into LMWH subgroup(117 cases) and UFH subgroup(83 cases). According to conventional method, the MACE what happened during percu- taneous coronary intervention procedure and post percutaneous coronary intervention 72 hours come from each group of patients was in- vestigated and these statistics were analysised so that evaluate the efficacy and safety of low molecular weight heparin and unfarction heparin. Results: (1) There were no statistical significance in baseline characteristics between the each group (P>0.05). (2) There were statistical significance in the incidence of TIMI flow slows between the each group (P<0.05), low molecular weight heparin is superior to unfarction heparin in terms of efficacy. (3)There were no statistical significance in death between the each group (P>0.05), but there were statistical significance in bleeding / hematoma complications, and other (pericardial tamponade, chest pain, cardiogenic shock, cardiac rupture, ventricular septal perforation, ventricular tachycardia, ventricular fibrillation,cardiac arrest, Aspen attack, stent thrombosis and so on) between the each group (P<0.05), low molecular weight heparin less adverse reactions, higher safety. Conclusion: Low molecular weight heparin in the percutaneous coronary intervention effect is more significant, and less than UFH adverse reactions and high safety, more suitable for percutaneous coronary intervention anticoagulant therapy.