stemi患者直接pci术中抗凝治疗

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1、重庆医科大学硕士研究生学位论文行的抗凝治疗方案的建议。关键字：比伐卢定，肝素，STEMI，直接PCI3万方数据重庆医科大学硕士研究生学位论文ANTICOAGULATIONTHERAPYINSTEMIPATIENTSDURINGPRIMARYPCIABSTRACTCoronaryheartdisease(CHD)istheoneofleadingcausesofdeathintheworld.Themainmechanismismyocardialischemiaandhypoxiathatcausedbycoronaryatheroscl

2、erosisluminalstenosisorobstruction.Andacutecoronarysyndrome(ACS)isanacuteclinicaltypeofCHD.Onthebasisofcoronaryatherosclerosis,whenatheromatousplaquecrackorbreakitexposethematerialthatwillleadtothrombosistothebloodstream.Thereforeitcausesplateletadhesiontoformthethrombus,

3、resultinginlesions’vesselscompleteorincompleteocclusion.SothekeytreatmentofACSliesinantithrombotictherapy.ForpatientswithST-segmentelevationmyocardialinfarction(STEMI),standardtreatmentisintendedtoquicklyreopentheblockedartery.Accordingtotheguidelinestheuseofprimarypercut

4、aneouscoronaryintervention(PPCI)isrecommendedforpatientswithSTEMIwhohaveanonsetofsymptomsoflessthan12hourswithin90–120minutes.SeverebleedingeventsareassociatedwiththeprognosisinACSpatientsafterPCI.Therefore,reducingbleedingcomplicationsisasimportantaspreventingischemiceve

5、nts.Alargenumberofclinicaltrialshaveprovedthatbivalirudin(asadirectthrombininhibitor)cannotonly4万方数据重庆医科大学硕士研究生学位论文reduceischemiceventsbutalsoreducebleedingevents,especiallyforNSTEACS(nonSTsegmentelevationacutecoronarysyndrome)patients.Thisadvantagehasbeenwidelyrecognized

6、.ButfortheacuteSTsegmentelevationmyocardialinfarction(STEMI)patientswhowillacceptprimaryPCI,itremainstobeahottopicthatwhetherheparinorbivalirudinisbetterforanticoagulation.ThispaperisaimedatsummarizingthemainresearchprogressonthetreatmentstrategyofprimaryPCIinSTEMIpatient

7、swithanticoagulation.BycombiningwiththecurrentactualsituationinChina,finallywewishtoprovidesomefeasiblesuggestionsforanticoagulationtreatment.Keyword:bivalirudin，heparin，STEMI，primaryPCI5万方数据重庆医科大学硕士研究生学位论文STEMI患者直接PCI术中抗凝治疗前言目前，冠心病仍然是全球死亡率最高的疾病之一。急性冠脉综合征（ACS）是冠心病的严重类型。无论

8、是欧洲还是美国的指南均推荐ACS患者早期介入治疗[5-7]联合抗栓药物治疗。其中包括双重抗血小板药物（阿司匹林和ADP受体拮抗剂）和恰当的抗凝治疗。一直以来，抗凝治疗方案的选择都是保证经皮冠状