利尿药干预下冠心病患者PCI治疗后二联抗血小板治疗与缺血事件的关系  

Relationship between Dual Antiplatelet Therapy Complicated with or without Diuretics and Ischemic Events in Patients with Coronary Heart Disease after Percutaneous Coronary Intervention

作　　者：毕秀 朱其恩 张国江 葛林 BI Xiu;ZHU Qien;ZHANG Guojiang;GE Lin(Department of Pharmacy,Tangshan Hospital of Traditional Chinese Medicine,Tangshan,Hebei 063000,China;Department of Cardiovascular Diseases 1 Ward,Tangshan Hospital of Traditional Chinese Medicine,Tangshan,Hebei 063000,China;Department of Classical Chinese Medicine,Tangshan Hospital of Traditional Chinese Medicine,Tangshan,Hebei 063000,China)

机构地区：[1]唐山市中医医院药学部,河北唐山063000 [2]唐山市中医医院心血管科一病区,河北唐山063000 [3]唐山市中医医院中医经典科,河北唐山063000

出　　处：《岭南心血管病杂志》2025年第1期21-27,39,共8页South China Journal of Cardiovascular Diseases

摘　　要：目的探讨利尿药对冠状动脉粥样硬化性心脏病(冠心病)患者经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗及二联抗血小板治疗后缺血事件的影响。方法回顾性分析2021年1月至2023年1月在唐山市中医医院治疗的108例冠心病患者的临床资料,其中利尿药组患者30例,无利尿药组患者78例。本研究对受试者进行了为期一年的追踪。运用Logistic回归分析对主要及联合缺血终点事件之间的潜在联系进行分析。采用单因素分析对无利尿药与利尿药组患者一般资料进行分析。分析利尿药对不同时点、不同分组、不同缺血事件危险分级患者的临床疗效。采用Kaplan-Meier曲线及Cox回归曲线分析利尿药与患者缺血终点事件的关系。结果Logistic回归分析结果显示利尿药应用是两种缺血终点事件的独立危险因素。无利尿药组与利尿药组患者缺血事件比较,差异有统计学意义(P<0.05)。在治疗8周时,无利尿药组低危和中危缺血事件患者的治疗效果优于利尿药组,差异有统计学意义(P<0.05)。Kaplan-Meier曲线及Cox回归曲线分析结果显示,利尿药组患者发生联合缺血终点事件的累计风险高于无利尿药组。结论当利尿药与PCI治疗及二联抗血小板治疗联合应用于冠心病患者时,患者面临心血管缺血终点事件风险增高的可能性。Objectives To investigate the effect of diuretics on ischemic events in patients with coronary artery disease who were treated with percutaneous coronary intervention and dual antiplatelet therapy.Methods Clinical data of 108 patients with coronary artery disease treated in Tangshan Hospital of Traditional Chinese Medicine from January 2021 to January 2023 were retrospectively analyzed,including 30 patients in diuretic group and 78 patients in no diuretic group.The patients were followed up for 1 year.Logistic regression analysis was performed to analyze the relationship of major ischemic endpoint events and combined ischemic endpoint events.General information of the patients in no diuretic group and diuretic group was analyzed by univariate analysis.The clinical characteristics of patients who had and did not have ischemic endpoint events were analyzed by univariate analysis.The effects of diuretics on the clinical outcomes of patients at different time points,in different subgroups,and with different risk grades for ischemic events were analyzed.The Kaplan-Meier curves and Cox regression curves were used to analyze the relationship of diuretics and patients′ischemic endpoint events.Results Logistic regression analysis showed that diuretics were the independent risk factors of ischemic endpoint events and combined ischemic endpoint events.Incidence of ischemic events between no diuretic group and diuretic group showed statistical significance(P<0.05).After 8 weeks of treatment,the patients with low and intermediate risk of ischemic events in no diuretic group had got better treatment outcomes than those in diuretic group(P<0.05).Kaplan-Meier curves and Cox regression curves analysis showed that the cumulative risk of a combined ischemic endpoint events was significantly higher in diuretic group than in no diuretic group.Conclusions The combination of diuretics with PCI and dual antiplatelet therapy in patients with coronary artery disease may increase the risk of cardiovascular ischemic endpoint events.

关 键 词：冠状动脉疾病 利尿药 血管成形术 经腔 经皮冠状动脉 二联抗血小板治疗 缺血事件 

分 类 号：R541.4[医药卫生—心血管疾病]