测量激活凝血时间 (ACT) 的不精确性从导导导管在穿皮冠状动脉干预期间
Aviv Y Pollak1, Ofer M Kobo1, Gilad Margolis1
1Cardiology, Hillel Yaffe Medical Center, Hadera, Israel.
概括
在穿皮冠状动脉干预 (PCI) 期间,从导导导管的活性凝血时间 (ACT) 测量显著高于从动脉外套的测量. 这种差异可能会影响PCI期间的抗凝血疗法和患者安全.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 医疗器械技术 医疗器械技术
背景情况:
- 穿皮冠状动脉干预 (PCI) 需要平衡缺血事件减少和出血风险.
- 在PCI期间,激活凝血时间 (ACT) 对于监测未分离肝素 (UFH) 抗凝血至关重要.
研究的目的:
- 在PCI过程中,与动脉接入相比,评估从引导导管中获得的ACT测量的准确性.
主要方法:
- 预期招募331名接受PCI与UFH治疗的患者.
- 从冠状动脉导导管和动脉接入外套同时采取血液样本以检测ACT.
- 对ACT值的分析和与临床变量的相关性.
主要成果:
- 导导导管 (294±77秒) 的平均ACT显著高于动脉外套 (250±60秒) 的平均ACT.
- 在两个采样地点之间观察到43±27秒的平均差异 (p < 0.001).
- 在30%的患者中,指导导管ACT超过250秒,而外套ACT低于250秒;在12%的患者中,指导导管ACT超过200秒,而外套ACT低于200秒.
结论:
- 很大一部分患者似乎从导导管中获得了治疗性ACT,而从动脉外套的读数表明了亚治疗水平.
- 在PCI期间,采样地点之间的ACT测量中的这种显著差异需要考虑临床和安全影响.
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