PCI术后合并急性胃黏膜出血的抗血小板方案疗效评价  

Curative effect of antiplatelet therapy on acute gastric mucosal bleeding after percutaneous coronary intervention

作　　者：杨东红[1] 刘茗[1] 薛剑 许爱斌 Yang Donghong;Liu Ming;Xue Jian;Xu Aibin(Third Department of Cardiology,People's Hospital of Langfang City,LangFang 065000,China;不详)

机构地区：[1]廊坊市人民医院心内三科,廊坊065000 [2]解放军总医院第六医学中心心血管病医学部,北京100089

出　　处：《中国循证心血管医学杂志》2023年第5期612-615,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的比较并评价不同抗血小板治疗方案对经皮冠脉介入治疗(PCI)术后急性胃黏膜病变出血患者的疗效。方法选取2018年11月至2019年8月于廊坊市人民医院心内科接受PCI且术后合并消化道出血的93例冠心病患者为研究对象,将患者随机分为单药替格瑞洛组(n=43,替格瑞洛90mg,2/d,口服)和常规双抗组(n=50,阿司匹林100mg,1/d,联合氯吡格雷75mg1/d口服),定期随访监测血小板聚集试验,观察和比较两组患者主要不良心血管事件(MACE)和临床出血事件情况。结果单药替格瑞洛组二磷酸腺苷(ADP)诱导的血小板聚集率显著低于常规双抗组(P<0.05)。两组共93例患者进行随访12个月,均未出现MACE事件。单药替格瑞洛组出血事件的发生风险与常规双抗组相比降低0.819(HR=0.819;95%CI:0.510~0.930)。结论替格瑞洛作为在临床上广泛使用的强效抗血小板聚集药物,其单药应用即可显著降低PCI术后合并急性胃黏膜病变出血后患者再次临床出血事件发生的风险。Objective To compare and review the curative effects of dfferent antiplatelet therapeutic plans in patients with acute gastric mucosal bleeding after percutaneous coronary intervention(PCI).Methods The patients(n=93)with coronary heart disease(CHD)undergone PCI and suffered from postoperative acute gastric mucosal bleeding were chosen from Department of Cardiology in People's Hospital of Langfang City from Nov.2018 to Aug.2019.All patients were divided randomly into ticagrelor group(n=43,90 mg of ticagrelor,2 times/d)and group of routine dual anti-platelet therapy(DAPT group,n=50 with 100 mg of aspirin and 75 mg of clopidogrel 1time/d).The results of platelet aggregation test(PagT)were followed up and monitored regularly,and incidence of major adverse cardiovascular events(MACE)and clinical bleeding events were observed and compared in 2 groups.Results The platelet aggregation rate(PAR)induced by adenosine diphosphate(ADP)were significantly lower in ticagrelor group than that in DAPT group(P<0.05).All patients were followed up for 12 months and there were no MACE occurred in 2 groups.Compared with DAPT group,the risk of bleeding events decreased by 0.819(HR=0.819,95%CI:0.510~0.930)in ticagrelor group.Conclusion Ticagrelor,as a potent anti-platelet aggregation drug,is widely used in clinical practice,and its singly administration can significantly reduce the risk of recurrence of clinical bleeding events in patients with acute gastric mucosal bleeding after PCI.

关 键 词：冠脉介入治疗 替格瑞洛 抗血小板聚集 急性胃黏膜病变出血 

分 类 号：R816.2[医药卫生—放射医学]