PCI术后双联抗血小板导致消化道大出血的相关因素分析  

Analysis on related factors of massive gastrointestinal hemorrhage caused by dual antiplatelet therapy after PCI

作　　者：李博[1] 欧柏青[1] 邓婷智[1] Li Bo;Ou Bai-qing;Deng Ting-zhi(Department of Geriatrics,the First Affiliated Hospital of Hunan Normal University,Changsha 410005,China)

机构地区：[1]湖南师范大学第一附属医院/湖南省人民医院老年病科,长沙410005

出　　处：《湖南师范大学学报（医学版）》2022年第2期19-22,共4页Journal of Hunan Normal University(Medical Sciences)

摘　　要：目的:探讨冠心病经皮冠状动脉介入术(PCI)术后双联抗血小板治疗中消化道大出血的相关危险因素.方法:收集湖南省人民医院2015年1月~2020年12月冠心病PCI术后患者1335例为研究对象,因消化道大出血再入院患者46例(占3.4%),纳入消化道大出血组;无消化道出血者1289例(占96.6%)用等距随机抽样法选出50例作为对照组.比较两组患者的性别、年龄、肾功能、低蛋白血症、糖尿病史、高血压史、高脂血症、吸烟史、饮酒史、联合口服PPI、血管病变支数等相关情况,探讨冠心病双联抗血小板治疗中消化道大出血的相关危险因素.结果:单因素logistic回归分析显示PCI术后消化道大出血组年龄≥65岁、肾功能异常、低蛋白血症、吸烟史占比高于对照组,联合口服PPI占比低于对照组.差异具有统计学意义,出血组与对照组在性别、高血压史、糖尿病史、饮酒史、血管病变支数病史两组比较差异无统计学意义.多因素logistic回归分析显示低蛋白血症是消化道大出血的独立危险因素.结论:高龄、肾功能异常、低蛋白血症、吸烟史等是PCI术后双联抗血小板导致消化道大出血的危险因素,尤其低蛋白血症是消化道大出血的独立危险因素,联合口服PPI是PCI术后消化道大出血的保护因素.Objective To investigate the related risk factors of massive gastrointestinal hemorrhage during dual antiplatelet therapy after PCI for coronary heart disease.Methods A total of 1335 patients with coronary heart disease after percutaneous coronary intervention(PCI)in Hunan Provincial People*s Hospital from 2015-01 to 2020-12 were enrolled.According to whether readmitted because of Massive gastrointestinal hemorrhage,the patients were divided into two groups.The Massive gastrointestinal hemorrhage group,n=46,Control group(using equidistant random sampling method to select patient from 1289 patients without gastrointestinal hemorrhage),n=50.The gender,age,renal function,hypoalbuminemia,history of diabetes,history of hypertension,history of hyperlipidemia,smoking history,drinking history,combined oral PPI,number of vascular lesions,etc.were compared between the two groups to explore Risk factors associated with severe gastrointestinal hemorrhage during dual antiplatelet therapy after PCI for coronary heart disease.Results Univariate logistic regression analysis showed that The proportions of age≥65 years,abnormal renal function,hypoalbuminemia and smoking history in the massive gastrointestinal hemorrhage group were higher than those in the control group,and the proportion of combined oral PPI was lower than that in the con-trol group.The difference was statistically significant,and there was no significant difference between the two groups in gender,history of hypertension,history of diabetes,history of drinking,and history of vascular lesions.Multivariate logistic regression analysis shows that hypoalbuminemia is an independent risk factor for Massive gastrointestinal hemorrhage.Conclusion Old age,abnormal renal function,hypoalbuminemia and smoking history are the risk factors for massive gastrointestinal hemorrhage caused by dual antiplatelet after PCI,In particular,hypoalbuminemia is an independent risk factor for massive gastrointestinal hemorrhage,combined oral PPI is a protective factor for massive gastroin

关 键 词：PCI 消化道大出血 相关因素 

分 类 号：R571[医药卫生—消化系统]