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1、重慶醫(yī)科大學(xué)碩士研究生學(xué)位論文行的抗凝治療方案的建議。關(guān)鍵字：比伐盧定，肝素，STEMI，直接PCI3萬方數(shù)據(jù)重慶醫(yī)科大學(xué)碩士研究生學(xué)位論文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)cannotonly4萬方數(shù)據(jù)重慶醫(yī)科大學(xué)碩士研究生學(xué)位論文reduceischemiceventsbutalsoreducebleedingevents,especiallyforNSTEACS(nonSTsegmentelevationacutecoronarysyndrome)patients.Thisadvantagehasbeenwidelyrecognized
6、.ButfortheacuteSTsegmentelevationmyocardialinfarction(STEMI)patientswhowillacceptprimaryPCI,itremainstobeahottopicthatwhetherheparinorbivalirudinisbetterforanticoagulation.ThispaperisaimedatsummarizingthemainresearchprogressonthetreatmentstrategyofprimaryPCIinSTEMIpatient
7、swithanticoagulation.BycombiningwiththecurrentactualsituationinChina,finallywewishtoprovidesomefeasiblesuggestionsforanticoagulationtreatment.Keyword:bivalirudin，heparin，STEMI，primaryPCI5萬方數(shù)據(jù)重慶醫(yī)科大學(xué)碩士研究生學(xué)位論文STEMI患者直接PCI術(shù)中抗凝治療前言目前，冠心病仍然是全球死亡率最高的疾病之一。急性冠脈綜合征（ACS）是冠心病的嚴(yán)重類型。無論
8、是歐洲還是美國的指南均推薦ACS患者早期介入治療[5-7]聯(lián)合抗栓藥物治療。其中包括雙重抗血小板藥物（阿司匹林和ADP受體拮抗劑）和恰當(dāng)?shù)目鼓委?。一直以來，抗凝治療方案的選擇都是保證經(jīng)皮冠狀
