赵丽军,梁明,李晶,荣晶晶,孙景阳,李毅,韩雅玲

• 1:沈阳军区总医院心内科
• 2:辽宁医学院

摘要(Abstract)：

目的评估急性心肌梗死(acute myocardial infarction,AMI)合并糖尿病患者急诊行经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)围术期应用比伐芦定的安全性及有效性。方法选取BRIGHT研究中AMI合并糖尿病行急诊PCI患者465例,其中比伐芦定组168例,肝素组137例,肝素联合替罗非班组160例。主要终点为术后30 d净不良临床事件(net adverse clinical event,NACE),包括主要不良心脑血管事件(major adverse cardiac and cerebral events,MACCE)及全部出血事件。结果所有患者均完成30 d临床随访。比伐芦定组NACE事件[17例(10.1%)比33例(20.6%),P=0.008]及全部出血事件[5例(3.0%)比20例(12.5%),P=0.001]发生率显著低于肝素联合替罗非班组;与肝素组相比有降低趋势[NACE:17例(10.1%)比22例(16.1%),P=0.122;全部出血事件:5例(3.0%)比10例(7.3%),P=0.082],但差异均无统计学意义。三组间MACCE和支架内血栓发生率比较,差异均无统计学意义(均P>0.05)。结论 AMI合并糖尿病患者急诊PCI围术期应用比伐芦定安全有效,与应用肝素或肝素联合替罗非班相比,可降低术后30 d的NACE和出血事件风险,且不增加MACCE和支架内血栓风险。

关键词(KeyWords)： 比伐芦定;糖尿病;急性心肌梗死;经皮冠状动脉介入治疗

Abstract:

Keywords:

基金项目(Foundation): 国家十二五科技支撑计划课题(2011BAI11B07)

作者(Author): 赵丽军,梁明,李晶,荣晶晶,孙景阳,李毅,韩雅玲

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