西洛他唑联合氯吡格雷血小板治疗对PCI术后老年患者的疗效及安全性  

Therapeutic effect and safety of cilostazol combined clopidogrel and aspirin on aged patients after PCI

作　　者：王四坤[1] 蒋毅[1] 王春明[1] 余浩[1] 陈苏[1] 胡晓军[1] 

机构地区：[1]湖北省新华医院心内科,湖北武汉430015

出　　处：《心血管康复医学杂志》2016年第1期75-78,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨西洛他唑联合氯吡格雷双联抗血小板治疗对经皮冠状动脉介入(PCI)术后老年患者的疗效及安全性。方法:100例行PCI术的老年冠心病患者被随机分为常规治疗组(52例,接受氯吡格雷+阿司匹林抗血小板治疗)和西洛他唑组(48例,在常规治疗组治疗基础上接受西洛他唑治疗)。用比浊法检测血小板聚集率(PAR),比较两组患者术前及术后1周、1月PAR及血小板平均体积(MPV)。随访6个月,比较两组患者主要不良心血管事件(MACE)及出血事件发生率。结果:术前两组MPV和PAR均无显著差异,与常规治疗组比较,术后1周及1月西洛他唑组PAR显著降低[术后1周:(48.7±6.3)%比(43.5±5.7)%,术后1月:(46.8±5.8)%比(42.4±5.4)%],P均<0.05。随访6个月后,西洛他唑组和常规治疗组的总MACE发生率(16.7%比17.3%)无显著差异,P>0.05;西洛他唑组的出血事件发生率显著低于常规治疗组(6.25%比19.23%,P<0.01)。结论:与氯吡格雷+阿司匹林抗血小板治疗比较,西洛他唑联合氯吡格雷抑制血小板聚集效果更显著,且出血事件明显减少,在PCI术老年冠心病患者中安全有效。Objective： To explore therapeutic effect and tients after percutaneous coronary intervention （PCI） safety of cilostazol combined clopidogrel ＋ aspirin on aged pa- Methods： A total of 100 aged patients with coronary heart disease undergoing PCI were randomly divided into routine treatment group （n = 52, received aspirin and clopidogrel antiplatelet therapy） and cilostazol group （n = 48, received cilostazol therapy based on routine treatment group）. Turbidimetry was used to measure platelet aggregation rate （PAR）; PAR and mean platelet volume （MPV） were compared between two groups before, one week and one month after PCI. All subjects were followed up for six months, incidence rates of major adverse cardiovascular events （MACE） and hemorrhage events were compared be- tween two groups. Results： There were no significant difference in MPV and PAR between two groups before PCI. Compared with routine treatment group, PAR significantly reduced Eone week after PCI： （48. 7 ± 6.3）% vs. （43.5 ± 5.7） %, one month after PCI： （46. 8 ± 5.8） % vs. （42.4 ± 5.4） %] in cilostazol group, P〈0.05 both. After six - month follow - up, there was no significant difference in total incidence rate of MACE （16. 7% vs. 17.3%） be- tween cilostazol group and routine treatment group, P〉0.05; incidence rate of hemorrhage in cilostazol group was significantly lower than that of routine treatment group （6. 25% vs. 19.23%, P〈0.01）. Conelusion： Compared with elopidogrel ＋ aspirin therapy, cilostazol combined clopidogrel ＋ aspirin can more significantly inhibit platelet ag- gregation, and significantly reduce hemorrhage events, so they are safe and effective in aged patients with coronary heart disease undergoing PCI.

关 键 词：血管成形术 气囊 冠状动脉 出血 血小板聚集抑制剂 西洛他唑 

分 类 号：R541.4[医药卫生—心血管疾病]