摘要
目的:通过临床对照研究探讨磺达肝癸钠抗凝治疗我国老老年急性心肌梗死(AMI)患者的疗效和安全性。方法:入选80岁以上老年AMI患者147例,所有患者均未行经皮冠状动脉介入术(PCI)或溶栓治疗,入院后随机分为观察组(n=73)和对照组(n=74)。在常规药物治疗基础上,观察组患者给予磺达肝癸钠2.5 mg,1次/日,对照组患者给予依诺肝素钠0.75mg/kg,每12h/次,根据体质量及肾功能调整剂量。两组患者均连用7d。从入院分组后即刻开始随访至出院后1个月,记录血、尿常规、生化、超声心动图参数及主要不良心脏事件(MACE)和不良反应事件。结果:观察组2例心源性死亡,6例发生反复不稳定性心绞痛(UAP),对照组2例死亡,5例反复UAP,两组均无非致死性心肌梗死发生,两组的MACE事件差异无统计学意义(11.0%vs.9.5%,P>0.05)。随访期间,两组血常规、尿常规、生化参数及超声心动图指标间无统计学意义。观察组总的小出血发生率(5.5%)略低于对照组(8.1%),但差异无统计学意义。两组均无大出血及皮疹发生。结论:对于80岁以上老老年AMI患者,应用磺达肝癸钠抗凝治疗是有效和安全的,与依诺肝素相比,磺达肝癸钠抗凝治疗的小出血事件较少,在出血风险方面具有潜在优势。
Objective：To explore the efficiency and safety of anticoagulation therapy with Fondaparinux in the elder elder patients with acute myocardial infarction （AMI）. Methods： All 147 cases with AMI （ t〉 80 years） were included into the study, and percutaneous coronary intervention （PCI） or thrombolysis therapy wasn＇t performed on all the included patients. All 147 cases were randomly divided into observation group （73 cases） and control group （74 cases） shortly after hospitalization. With routine drug therapy for AMI, the pa- tients in observation group were given Fondaparinux subcutaneously, 2. 5 mg, once a day, and the patients in control group were given enoxaparin subcutaneously, 0.75mg/kg, 12h each time. and anticoagution therapy was performed on all cases for seven days. The follow-up were performed until one month after discharge and the parameters of blood routine, urine routine, biochemical analysis, electrocardiography, echocardiography, and major adverse cardiovascular events （MACE） and adverse effects in both groups were recorded. Results： There were two cardiogenic death events in each group, and there were 6 cases and 5 cases with unstable angina pectoris （UAP） respectively in observation group and control group, and there was no non-fatal infarction in both groups, and there was no difference in MACE between the both groups （P 〉 0. 05 ）. There was no differ- ence in blood routine, urine routine, biochemical analysis, electrocardiography, echocardiography between bothgroups. Incidence of minor bleeding events in observation group was a little lower than that in control group, but there was no significant difference （5.5% vs. 8.1%, P 〉 0. 05 ）. Conclusion： Anticoagulation therapy with Fondaparinux in the eider elder patients with acute AMI is effective and safe, and Fondaparinux has potential advantage on hemorrhage risk compared with enoxaparin.
出处
《心肺血管病杂志》
2017年第4期251-255,共5页
Journal of Cardiovascular and Pulmonary Diseases
基金
北京市卫生系统高层次人才培养计划(2014-3-042)
关键词
磺达肝癸钠
急性心肌梗死
抗凝治疗
Fondaparinux
Acute myocardial infarction
Anticoagnlation therapy
