中国医学工程2025，Vol.33Issue(4)：68-72,5.DOI:10.19338/j.issn.1672-2019.2025.04.014
比伐卢定对溶栓失败AMI的应用价值研究
Application value of bivalirudin in treatment for acute myocardial infarction with thrombolytic failure
摘要
Abstract
[Objective]To observe the application value of bivalirudin in acute myocardial infarction(AMI)patients who have failed thrombolysis.[Methods]This study was a prospective study,in which 112 AMI patients admitted to Huanghe S&T College Affiliated Hospital from May 2021 to May 2023 were randomly selected.The enrolled patients were randomly divided into the heparin group(56 cases)and the bivalirudin group(56 cases)using computer randomization method.After thrombolysis failure,both groups received percutaneous coronary intervention(PCI)for salvage treatment.The heparin group received heparin adjuvant treatment,while the bivalirudin group received bivalirudin adjuvant treatment.The myocardial perfusion,changes in myocardial injury biomarker levels,cardiac function recovery,and prognosis of the two groups of patients were compared.[Results]Under different treatment regimens,the proportion of thrombolysis in myocardial infarction(TIMI)grade 3 and TIMI myocardial perfusion grade(TMPG)3 in the bivalirudin group was 85.71%(48/56)and 91.07%(51/56),higher than the heparin group[62.50%(35/56)and 67.86%(38/56)](P<0.05).The corrected TIMI frame count(cTFC)of the bivalirudin group(30.23±5.24)was lower than the heparin group(33.46±5.33),with a PI of 55.62%±10.44%higher than the heparin group(50.35%±10.21%)(P<0.05).The myoglobin(MYO),creatine kinase myocardial band(CK-MB),and lactate dehydrogenase(LDH)of the bivalirudin group were 61.23±10.41 μg/L,10.25±2.31 U/L,and 40.22±10.25 U/L,all lower than those in the heparin group(66.43±10.28 μg/L,12.41±3.25 U/L,45.62±10.31 U/L)(P<0.05).The left ventricular ejection fraction(LVEF)of the bivalirudin group(55.18%±10.29%)was higher than the heparin group(50.31%±10.24%),and the left ventricular end-diastolic volume(LVEDV)and left ventricular end-systolic volume(LVESV)(115.32±20.33 mL and 55.27±10.25 mL)were lower than the heparin group(130.25±20.32 mL and 60.41±10.28 mL)(P<0.05).The incidence of adverse prognosis in the bivalirudin group was 5.36%(3/56),lower than the heparin group[21.43%(12/56)](P<0.05).[Conclusion]Bivalirudin assisted salvage PCI can improve myocardial perfusion in AMI patients,and has a positive significance in reducing myocardial injury,promoting cardiac function recovery,and reducing the risk of adverse prognosis.关键词
急性心肌梗死/溶栓失败/经皮冠脉介入术/比伐卢定/心肌灌注Key words
acute myocardial infarction/thrombolysis failure/percutaneous coronary intervention/bivalirudin/myocardial perfusion分类
医药卫生引用本文复制引用
侯曼利,闫杰,罗佩佩,王阳阳..比伐卢定对溶栓失败AMI的应用价值研究[J].中国医学工程,2025,33(4):68-72,5.基金项目
河南省医学科技攻关项目(LHGJ2020021837) （LHGJ2020021837）
