三联抗血小板药物对缺血性脑血管病患者冠状动脉介入治疗术后的近期疗效  

Short-term efficacy of triple antiplatelet therapy in patients with ischemic cerebral vascular disease after percutaneous coronary intervention

作　　者：韩雅玲[1] 肖艳平[1] 邓捷[1] 李成洋[1] 徐凯[1] 

机构地区：[1]沈阳军区总医院全军心血管病研究所心内科,辽宁沈阳110016

出　　处：《中华老年心脑血管病杂志》2007年第3期149-151,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：全军临床高新技术重大基金资助(2002卫医字第18号)

摘　　要：目的探讨既往有缺血性脑血管事件发作史的冠心病患者行经皮冠状动脉介入治疗(PCI)后应用西洛他唑联合阿司匹林和氯吡格雷三联抗血小板治疗方案的近期疗效和安全性。方法回顾性分析有缺血性脑血管病史且接受PCI治疗的冠心病患者共216例,其中80例PCI后应用三联抗血小扳治疗(三联组),136例PCI后应用阿司匹林联合氯吡格雷两联抗血小板治疗(两联组)。观察两组PCI后30天主要不良心脑血管事件(MACCE)、亚急性血栓和出血发生率结果两组临床基线特征及PCI即刻结果无差异,术中均无死亡;三联组患者30天病死率、脑卒中发生率、MACCE发生率均显著低于两联组(P值分别<0．05,<0．05,<0．01)。两组亚急性血栓、30天主要出血事件、脑出血发生率差异均无显著性意义。结论有缺血性脑血管病史患者PCI后应用氯吡格雷、阿司匹林和西洛他唑三联抗血小板治疗后,可显著降低近期死亡、脑卒中及MACCE发生率,且不增加脑出血等副作用。Objectlve To evaluate short-term efficacy and safety of triple antiplatelet regimen （cilostazol combined with clopidogrel and aspirin） in treatment of patients with coronary heart disease （CHD） concomitant with ischemic cerebral vascular disease （ICVD） history after percutaneous coronary intervention （PCI）. Methods A total of 216 PCI patients with ICVD history in this hospital were analyzed retrospectively. Of them, 80 were treated with cilostazol 100 mg twice a day in addition to aspirin and clopidogrel as triple antiplatelet therapy regimen （triple group） after PCI, and 136 received aspirin and clopidogrel as dual antiplatelet therapy regimen after PCI （control group）. The data of the incidences of major adverse cardiac and cerebral vascular events （MACCE）, subacute in-stent thrombosis （SAT）, and hemorrhage events within 30 days after PCI of the two groups were analyzed. Results The baseline clinical characteristics and the immediate outcomes of PCI were similar in patients between the two groups, with no death occurred during the procedure in both groups. The mortality and the rates of stroke and MACCE within 30 days after PCI in the triple group were significantly lower than those in the control group （ P 〈 0.05, P 〈 0.01）. However, there were no significant differences in the incidence rates of SAT, major hemorrhage events and cerebral hemorrhage between the two groups. Conclusion This novel triple antiplatelet regimen （aspirin and clopidogrel combined with cilostazol） used for PCI patients with ICVD history does not increase the incidence of cerebral hemorrhage and can reduce mortality, incidences of MACCE and stroke remarkably during 30-day observation period.

关 键 词：血小板聚集抑制剂 脑缺血 血管成形术 经腔 经皮冠状动脉 

分 类 号：R743[医药卫生—神经病学与精神病学]