上海安亭镇社区60岁以上高血压患者服用阿司匹林对心脑血管事件的影响  

Effect of aspirin on cardio-cerebral vascular events in hypertensive patients over 60 years old in Anting Community,Shanghai

作　　者：蒋玉婷[1] 薛晨昱 周治彤 李觉[2] 沈志萍 JIANG Yuting;XUE Chenyu;ZHOU Zhitong;LI Jue;SHEN Zhiping(Central Team of Anting Community Health Service Center of Jiading District,Shanghai 201800,China;Department of Epidemiology of School of Medicine,Tongji University,Shanghai 200331,China;Department of Administration of Anting Community Health Service Center of Jiading District,Shanghai 201800,China)

机构地区：[1]上海市嘉定区安亭镇社区卫生服务中心中心团队,上海201800 [2]同济大学医学院流行病学教研室,上海200331 [3]上海市嘉定区安亭镇社区卫生服务中心行政科,上海201800

出　　处：《上海医药》2024年第14期58-62,共5页Shanghai Medical & Pharmaceutical Journal

基　　金：嘉定区卫生健康委员会科研立项项目(青年)(2020-QN-04)。

摘　　要：目的:探讨服用阿司匹林对60岁以上高血压患者心脑血管事件的影响。方法:选取上海安亭社区卫生服务中心慢性病系统中2018年1月至12月纳入的高血压患者4488例,其中男性2075例(46.2%),女性2413例(53.8%),平均年龄(69.76±6.80)岁。根据服用阿司匹林情况分为服药组(910例)与不服药组(3578例)。随访至2020年12月31日,记录随访中出现的临床终点事件。用Kaplan-Meier生存曲线及Cox回归模型评价服用阿司匹林对心脑血管事件的影响。结果:Kaplan-Meier生存曲线分析显示,服药组心脑血管事件、脑梗死和全因死亡的风险明显下降(RR=0.38,95%CI:0.21~0.66,P=0.001;RR=0.29,95%CI:0.15~0.55,P<0.001和RR=0.19,95%CI:0.07~0.51,P=0.001),心肌梗死的发生风险增加(RR=22.66,95%CI:1.9~266.93,P=0.013)。结论:长期服用阿司匹林可总体上降低高血压患者发生心脑血管事件的风险,且未增加脑出血的风险。结论尚需大样本、前瞻性研究进一步验证。Objective:To investigate the effect of aspirin on cardio-cerebral vascular events in hypertensive patients over 60 years old.Methods:From January 2018 to December 20184488 hypertensive patients were selected from the chronic diseases management in Anting Community Health Service Center in Shanghai,among them,there were 2075 males(46.2%),2413 females(53.8%)and the average age was(69.76±6.80)years.Based on the condition of taking aspirin,the patients were divided into an aspirin group with 910 cases and a non-aspirin group with 3578 cases.The following up ended until December 31,2020,and clinical endpoint events were recorded during follow-up.Kaplan-Meier survival curve and Cox regression mode were used to evaluate the effect of aspirin on cardio-cerebral vascular events.Results:Kaplan-Meier survival curve analysis showed that the risk of cardio-cerebral vascular events,cerebral infarction and all-cause death significantly reduced in the aspirin group(RR=0.38,95%CI:0.21-0.66,P=0.001,RR=0.29,95%CI:0.15-0.55,P<0.001 and RR=0.19,95%CI:0.07-0.51,P=0.001),the risk of myocardial infarction significantly increased(RR=22.66,95%CI:1.9-266.93,P=0.013).Conclusion:Long-term use of aspirin in hypertensive patients can reduce the incidence of cardio-cerebral vascular events,and does not increase the risk of cerebral hemorrhage.More evidence-based medical evidence is needed for further validation through prospective studies.

关 键 词：高血压 阿司匹林 心脑血管事件 一级预防 

分 类 号：R544.1[医药卫生—心血管疾病]