摘要
Abstract
Objective To explore the therapeutic effects of bivalirudin on patients with acute coronary syndrome(ACS)undergoing percutaneous coronary intervention(PCI).Methods From January 2020 to December 2023,60 ACS patients undergoing PCI at the Second People's Hospital of Xinxiang were selected and randomly divided into an observation group and a control group,with 30 patients in each.The control group received intravenous heparin sodium injection before surgery,while the observation group received bivalirudin injection.The activated clotting time at different intervals and bleeding status at 7 days post-surgery were observed.Coagulation parameters,troponin T(cTnT),and ischemia-modified albumin(IMA)levels before and 24 hours after surgery were compared between the two groups.Changes in left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-diastolic volume(LVEDV),and left atrial diameter(LAD)were analyzed preoperatively and two months postoperatively.The incidence of major adverse cardiovascular events during one-year follow-up was evaluated for both groups.Results The observation group showed significantly higher activated clotting times at 5 minutes after administration,at the end of surgery,and 2 hours after stopping the drug compared to the control group,with all differences being statistically significant(P＜0.05).However,no significant differences were observed in activated clotting time between the groups preoperatively and 30 minutes after stopping the drug(P＞0.05).The postoperative bleeding rate was significantly lower in the observation group than in the control group(P＜0.05).At 24 hours post-surgery,activated partial thromboplastin time(APTT),thrombin time(TT),and prothrombin time(PT)were significantly higher,while fibrinogen(FIB),cTnT,and IMA levels were significantly lower compared to pre-surgery in both groups,with statistical significance(P＜0.05).The observation group had significantly longer APTT,TT,PT,and lower levels of FIB,cTnT,and IMA compared to the control group at 24 hours post-surgery(P＜0.05).Two months post-surgery,both groups showed significant improvement in left ventricular ejection fraction,with reductions in LVEDD,LVEDV,and LAD(P＜0.05).LVEF in the observation group was significantly higher,while LVEDD,LVEDV,and LAD were significantly lower than those in the control group at two months post-surgery(P＜0.05).During the one-year follow-up,there was no statistically significant difference in the incidence of major adverse cardiovascular events between the two groups(P＞0.05).Conclusion Bivalirudin treatment in ACS patients undergoing PCI effectively reduces coagulation activity,enhances coronary blood circulation,alleviates myocardial ischemia,improves cardiac function efficiency,and shows promising recovery prospects.关键词
比伐芦定/急性冠脉综合征/静脉注射/肝素/射血分数Key words
Bivalirudin/acute coronary syndrome/intravenous injection/heparin/ejection fraction分类
医药卫生
