阿替普酶联合伊诺肝素钠应用于急性前壁心肌梗死PCI患者的抗凝效果分析

目的探讨阿替普酶联合伊诺肝素钠应用于急性前壁心肌梗死经皮冠状动脉介入治疗患者的抗凝效果分析。方法前瞻性选取2019年12月至2021年2月如皋市人民医院收治急性前壁心肌梗死经皮冠状动脉介入治疗患者197例为研究对象,按照随机数字表法分为观察组(n=99)和对照组(n=98)。对照组采用阿替普酶、氯吡格雷及阿司匹林进行治疗,观察组在对照组基础上联合伊诺肝素钠进行治疗。比较两组患者治疗效果、溶栓后血管再通情况、激活凝血酶时间(ACT)、病死率及不良反应发生率。结果与对照组相比,观察组优良率较高(93.94%vs. 81.63%),且病死率及不良反应发生率较低(6.06%vs. 20.41%和40.40%vs. 55.10%),差异均有统计学意义(P <0.05)。与对照组相比,观察组患者溶栓后60、90、120 min血管再通率较高(49.49%vs. 29.59%、72.72%vs. 52.04%、79.79%vs.63.26%),差异均有统计学意义(P <0.05)。与对照组相比,观察组ACT <225 s及ACT> 500 s患者比率较低(2.02%vs. 15.31%、5.05%vs. 9.18%),ACT 225~500 s患者比率较高(92.92%vs. 71.42%),差异均有统计学意义(P <0.05)。结论阿替普酶联合伊诺肝素钠应用于急性前壁心肌梗死经皮冠状动脉介入治疗患者能提高疗效,降低病死率及不良反应发生率,提高溶栓后血管再通率及激活凝血酶时间数值。

Anticoagulant effect of alteplase combined with enoxaparin sodium in PCI patients with acute anterior myocardial infarction

Objective To investigate the anticoagulant effect of alteplase combined with enoxaparin sodium in patients with acute anterior myocardial infarction by percutaneous coronary intervention. Methods A total of 197 patients with acute anterior myocardial infarction by percutaneous coronary intervention in the People’s Hospital of Rugao from December 2019 to February 2021 were prospectively selected and divided into observation group( n = 99) and control group( n = 98) by random number table. The control group was treated with alteplase,clopidogrel and aspirin,and the observation group was treated with enoxaparin sodium on the basis of the control group. The treatment effect,vascular recanalization after thrombolysis,thrombin activation time( ACT),mortality rate and incidence of adverse reactions were compared between the two groups of patients. Results Compared with the control group,the observation group had a higher excellent rate( 93. 94% vs. 81. 63%),and had a lower incidence of mortality and adverse reactions( 6. 06% vs. 20. 41% and 40. 40% vs. 55. 10%),the differences were statistically significant( P< 0. 05). Compared with the control group,patients in the observation group had a higher rate of vascular recanalization 60 min after thrombolysis,90 min after thrombolysis and 120 min after thrombolysis( 49. 49% vs. 29. 59%,72. 72% vs. 52. 04%,79. 79% vs. 63. 26%),the differences were statistically significant( P < 0. 05). Compared with the control group,the observation group had a lower rate of patients with ACT <225 s and ACT > 500 s( 2. 02% vs. 15. 31%,5. 05% vs. 9. 18%),and a higher rate of patients with ACT 225 ~ 500 s( 92. 92% vs. 71. 42%),the differences were statistically significant( P < 0. 05). Conclusion Alteplase combined with enoxaparin sodium in patients with acute anterior myocardial infarction by percutaneous coronary intervention can improve the efficacy,reduce the mortality and the incidence of adverse reactions,increase the vascular recanalization rate after thrombolysis and activated partial thromboplastin time.