冠脉搭桥术后抗血小板药物治疗远期出血事件发生的相关预测指标  

Related predictors of long term hemorrhagic events post-CABG antiplatelet therapy

作　　者：吴丹娜[1,2] 朱艳[1] 余成[3] 韩方璇[2] 徐萍[1] WU Dan-na;ZHU Yan;YU Cheng;HAN Fang-xuan;XU Ping(Department of Pharmacy, The Second Xiangya Hospital, Central South University, Hunan Changsha 410011, China;Department of Pharmacy;Department of Cardiac Surgery, Hainan General Hospital, Hainan Haikou 570311, China)

机构地区：[1]中南大学湘雅二医院药学部,湖南长沙410011 [2]海南省人民医院药学部,海南海口570311 [3]海南省人民医院心脏外科,海南海口570311

出　　处：《中国医院药学杂志》2018年第7期759-762,共4页Chinese Journal of Hospital Pharmacy

基　　金：海南省科协青年科技英才学术创新计划项目(编号:QCXM201814)

摘　　要：目的:预测冠脉搭桥术后抗血小板治疗远期发生出血事件的预测参数及界值。方法:对冠脉搭桥术后双联抗血小板治疗且行血栓弹力图检测的90例患者随访1年,记录患者是否发生事先预定的出血事件。结果:体重指数[OR=1.276,CI(1.025,1.589),P<0.05]与远期出血事件发生呈正相关,体重指数27.04 kg·m-2[ROC曲线下面积0.661,CI(0.498,0.825),灵敏度0.385,特异度0.922]是预测界值。结论 :应控制体重指数不超过27.04 kg·m-2以减少冠脉搭桥术后远期发生出血事件的可能性,本实验未得到血栓弹力图指标对其的预测价值,存在与以往研究得到的PCI术后患者的预测指标和界值不一致的可能性。OBJECTIVE To obtain the TEG cut points for diagnosing hemorrhagic events following post-CABG antiplatelet therapy. METHODS Ninety patients with CABG were treated with double antiplatelet in combination with TEG detection,and followed up for one year. The hemorrhagic events were followed up by telephone. RESULTS BMI [OR = 1. 276,CI（ 1. 025,1. 589）,P〈0. 05] was positively associated with occurrence of long term hemorrhagic events. BMI = 27. 04 kg·m^-2[the area under the ROC curve= 0. 661,CI（ 0. 498,0. 825）,sensitivity = 0. 385,specificity = 0. 922] determined by ROC curve analysis was the diagnostic threshold. CONCLUSION Different cut points have been obtained to predict hemorrhagic events in post-CABG patients. The predicted value of TEG is not available. BMI is a risk factor for hemorrhagic events. The goal of BMI control should be no higher than 27. 04 kg·m^-2 to decrease the risk for hemorrhagic events.

关 键 词：冠脉搭桥 血栓弹力图 抗血小板药物 体重指数 出血事件 

分 类 号：R969[医药卫生—药理学] R541.4[医药卫生—药学]