磺达肝癸钠治疗急性冠脉综合征的效果与安全性评价

目的观察急性冠脉综合征患者采用磺达肝癸钠治疗前后凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)变化及其安全性和有效性。方法急性冠脉综合征患者92例,随机分为实验组(磺达肝癸钠组,60例)和对照组(低分子肝素组,32例),两组患者基础治疗相同,入院时查PT、APTT,实验组给予磺达肝癸钠2.5 mg/d皮下注射,连用8 d或直至出院;对照组给予低分子肝素5 000 U,皮下注射,1次/12 h,连用8 d或直至出院。用药3 d后复查两组PT、APTT,行冠状动脉造影检查,必要时行经皮冠状动脉介入治疗。观察住院期间和出院后30 d时心脏事件发生情况。结果实验组和对照组抗凝前PT、APTT水平差异无统计学意义(P>0.05);抗凝后PT、APTT水平差异有统计学意义(P<0.05)。两组患者住院期间均未发生急性心肌梗死、卒中及死亡;实验组再发心绞痛2例,出血2例;对照组再发心绞痛2例,出血4例。两组出院后30 d无急性心肌梗死、出血、卒中及死亡病例发生;实验组再发心绞痛5例,对照组再发心绞痛3例。两组并发症间差异均无统计学意义(P>0.05)。结论磺达肝癸钠治疗急性冠脉综合征安全有效。用磺达肝癸钠治疗急性冠脉综合征过程中PT、APTT水平有明显延长。

The Effect and Security of Fondaparinux Na in Treatment of Acute Coronary Syndrome

Objective To observe the effect and security of fondaparinux Na in treatment of acute coronary syndrome and whether the PT(prothrombin time) or APTT(activated partial thromboplastin time) of the patients in ACS(acute cornary syndrome) is changed after they using fondaparinux Na.Methods 92 patients with ACS were selected and randomly divided into experimental group(60 cases)and control group(32 cases).Besides the same basic treatment,the experimental group were given fondaparinux Na 2.5 mg per day subcutaneously for 8 days or until discharged and 5 000 U low molecular weight heparin was administrated to the control group subcutaneously every 12 hours for 8 days or until discharged.Both the two groups were checked blood clotting when the admission and re-checked after 3 days′ treatment.Patients of the two groups were treated with coronary angiography or PCI,if necessary.Occurrences of cardiac disease were observed for 30 days.Results The change of the PT or APTT of the patients of ACS was statistically significant in the experimental group.Occurrences of angina,cardial infarction and death situation had no difference between the two groups.Hemorrhage in the experimental group were obviously less than the control group.Conclusion Fondaparinux Na is safe and effective in the treatment of ACS and the PT or APTT of the patients in ACS is changed after they using fondaparinux Na.