基层医院经皮冠状动脉介入治疗术后中断抗血小板药物对预后的影响  

Prognosis of Interruption Antiplatelet After PCI with Grassroots Coronary Heart Disease

作　　者：王振娟[1] 周树军[1] 宗文仓[1] 张立强[1] 王云梅[1] 孔令军[1] 娄志刚[1] 

机构地区：[1]河北省玉田县医院,河北唐山064199

出　　处：《中国药业》2016年第7期95-96,F0003,共3页China Pharmaceuticals

摘　　要：目的探讨基层医院冠状动脉粥样硬化性心脏病(简称冠心病)患者接受经皮冠状动脉介入治疗术(PCI)后中断双联抗血小板药物对预后的影响。方法选取2011年至2014年在医院被确诊为冠心病并行PCI的患者180例,临床药师进行随访。根据随访患者服药的情况,将患者分为持续用药组(138例)及停药组(42例),比较两组患者终点事件的发生情况。采用单因素及多因素分析COX比例风险模型分析抗血小板治疗持续性及停药对终点事件的影响。结果持续用药组主要不良事件(MACE)及因心血管事件再入院的发生率显著低于停药组(P<0.05)。调整危险因素发现,持续用药是MACE及因心血管事件再入院的保护因素(P<0.05);停药是MACE及因心血管事件再入院的危险因素(P<0.05)。结论基层冠心病且行PCI治疗的患者,中断抗血小板用药显著增加了心血管事件的发生。持续用药是心血管事件的保护因素,中断用药是危险因素。Objective To evaluate the prognosis of interruption dual antiplatelt therapy after percutaneous coronary intervention（ PCI）with grassroots coronary heart disease. Methods 180 patients who received drug- eluting stents from 2011 to 2014 were selected and were followed by the cclinical pharmacists. According to the situation of medication, patients were divided into the continuous treatment group（ 138 cases） and withdrawal group（ 42 cases）. The incidence of endpoint events were compared between the two groups. Univariate and multivariate COX proportional hazards model were used to analyze the antiplatelet therapy on sustained and withdrawal of endpoint events. Results The major adverse events（ MACE） and readmissions due to cardiovascular events of the continuous treatment group of were significantly lower than the withdrawal group（ P〈0. 05）. Adjustment of risk factors found out than continued drug use was a protective factor of MACE and rehospitalization for cardiovascular events（ P〈0. 05）; withdrawal is a risk factor of MACE and rehospitalization for cardiovascular events（ P〈0. 05）. Conclusion For patients with coronary heart disease and undergoing PCI treatment,the interruption of antiplatelet drugs significantly increases the incidence of cardiovascular events. Continued drug use is a protective factor for cardiovascular events,and the interruption of medication is a risk factor.

关 键 词：抗血小板药物 经皮冠状动脉介入治疗术 心血管事件 

分 类 号：R969.4[医药卫生—药理学] R973.2[医药卫生—药学]