Anand S
McMaster University, Hamilton General Hospital, Hamilton, Ont., Canada.
Haemostasis. 1999 Dec;29 Suppl S1:76-8. doi: 10.1159/000054117.
Direct thrombin inhibitors may offer advantages over indirect thrombin inhibitors in the management of patients with acute coronary syndromes (ACS). Two direct thrombin inhibitors, hirudin and bivalirudin, have been investigated in Phase II and Phase III clinical trials. Based on the results of a meta-analysis of study data from 25,000 patients, hirudin appears to be more effective than unfractionated heparin (UFH) in the treatment of patients with ACS, but it is associated with an increased rate of major bleeding. A meta-analysis of a smaller patient population has suggested that bivalirudin, too, may be more efficacious than UFH and may also be safer.
在急性冠状动脉综合征（ACS）患者的治疗中，直接凝血酶抑制剂可能比间接凝血酶抑制剂具有优势。两种直接凝血酶抑制剂，水蛭素和比伐卢定，已在II期和III期临床试验中进行了研究。基于对25000名患者研究数据的荟萃分析结果，水蛭素在治疗ACS患者方面似乎比普通肝素（UFH）更有效，但它与大出血发生率增加有关。对较小患者群体的荟萃分析表明，比伐卢定也可能比UFH更有效，并且可能更安全。
