双联抗血小板聚集药物对PCI患者上消化道出血的影响  

The Effect of Dual Anti-platelet Treatment on Upper Gastrointestinal Bleeding after Percutaneous Coronary Intervention

作　　者：冯雪[1] 张志广[1] 李熳[1] 

机构地区：[1]天津医科大学第二医院,300211

出　　处：《天津医药》2014年第3期251-253,共3页Tianjin Medical Journal

基　　金：天津市卫生局科技基金(项目编号:07KG8)

摘　　要：目的探讨双联抗血小板聚集药物在经皮冠状动脉介入治疗(PCI)患者中致上消化道出血的发生情况及其相关危险因素。方法收集2 004例服用双联抗血小板聚集药物PCI患者的临床资料,包括性别、年龄、体质指数(BMI)、服药时间、既往消化道病史、吸烟史、饮酒史、高血压病史、糖尿病病史、脑血管病史、联用质子泵抑制剂(PPI)及实验室检查指标异常等情况。比较不同因素的消化道出血情况,分析上消化道出血的影响因素。结果年龄≥65岁、吸烟史、高血压病史、血小板数量异常、肌酐升高、血红蛋白异常是双联抗血小板聚集药物致PCI患者上消化道出血的危险因素,联用PPI是出血的保护因素。结论应加强对双联抗血小板聚集药物致消化道出血的认识,采取适宜措施,降低PCI患者的消化道出血发生率。Objective To investigate the risk factors of dual anti-platelet treatment in upper gastrointestinal hemor-rhage after percutaneous coronary intervention （PCI）. Methods Clinical data of 2004 PCI patients with dual anti-platelet treatment were collected,including gender,age,body mass index （BMI）,history of drug therapy, history of digestive disease, history of smoking and drinking,history of hypertension,history of diabetes,history of cerebrovascular disease and history of combined treatment with a proton pump inhibitor （PPI）. The different characteristics of gastrointestinal bleeding were com-pared. The risk factors of upper gastrointestinal bleeding were analyzed. Results The risk factors for PCI patients with up-per gastrointestinal bleeding were age＆gt;65 years of old, history of smoking, history of hypertension,abnormal platelet count, creatinine and hemoglobin. The combined treatment with a proton pump inhibitor was a protective factor associated with gas-trointestinal bleeding. Conclusion We should pay attention to the upper gastrointestinal bleeding induced by dual anti-platelet treatment, and take appropriate measures to reduce the incidence of gastrointestinal bleeding in PCI patients.

关 键 词：血小板聚集抑制剂 胃肠出血 血管成形术 经腔 经皮冠状动脉 质子泵抑制剂 

分 类 号：R571[医药卫生—消化系统]