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《慢性病学杂志》[ISSN:1674-8166/CN:11-5900/R]

卷:

期数:

2017年04期

页码:

359-362

栏目:

论著

出版日期:

2017-05-20

文章信息/Info

Title:

The influence of different doses of clopidogrel on cardiovascular ischemia and hemorrhage rate in elderly patient after percutaneous coronary intervention

作者:

李帅¹;  刘兵²

1. 商丘市第一人民医院CCU 科，河南商丘476000； 2. 商丘职业技术学院园林食品加工系，河南商丘476000

Author(s):

LI Shuai*;  LIU Bing

*Department of CCU, the First People's Hospital of Shangqiu, Shangqiu, Henan 476000, China Corresponding author: LI Shuai, E-mail: hkdh252@126.com

关键词:

氯吡格雷; 老年患者; 经皮冠状动脉介入治疗; 心血管缺血; 出血事件

Keywords:

Clopidogrel;  Elderly patient;  Percutaneous coronary intervention;  Cardiovascular ischemia;  Bleeding events

分类号:

R541.4

DOI:

-

摘要:

目的探讨不同剂量氯吡格雷对老年患者经皮冠状动脉介入治疗（PCI） 术后心血管缺血及出血事件发生 率的影响。方法选取商丘市第一人民医院2014 年8 月—2015 年8 月择期实施PCI 术的122 例老年冠心病患 者，随机分为两组，各61 例。小剂量组：75 mg/d 氯吡格雷与100 mg/d 阿司匹林；大剂量组：100 mg/d 氯吡 格雷与100 mg/d 阿司匹林。统计两组PCI术后12 个月心血管缺血及出血事件发生率，并对两组血栓弹力图检测 数据（反应时间、凝血时间、凝固角、最大幅度）、药物（阿司匹林抑制与氯吡格雷抑制） 效果进行观察比较。 结果大剂量组PCI 术后12 个月心血管缺血发生率31.15%，低于小剂量组的62.30%；大剂量组再出血事件发 生率24.59%，高于小剂量组的4.92%，差异均有统计学意义（P＜0.05）；两组凝固角差异无统计学意义（P＞ 0.05）；与小剂量组相比，大剂量组最大幅度较低，凝血及反应时间较高，差异有统计学意义（P＜0.05）；两组阿 司匹林抑制率差异无统计学意义（P＞0.05）；与小剂量组相比，大剂量组氯吡格雷抑制率较高，差异有统计学意 义（P＜0.05）。结论老年患者PCI术后维持100 mg/d氯吡格雷治疗，虽可有效减少心血管缺血事件发生，但 会一定程度增加出血风险，临床治疗中应予以重视

Abstract:

Objective To investigate the influence of different doses of clopidogrel on cardiovascular ischemia and hemorrhage rate in elderly patient after percutaneous coronary intervention (PCI). Methods A total of 122 patient elderly patients treated with PCI from August 2014 to August 2015 were divided into two groups according to the dose of clopidogrel, 61 cases in each group. The small dose group was given clopidogrel with 75 mg/d and aspirin with 100 mg/d; the large dose group was given clopidogrel with 100 mg/d and aspirin with 100 mg/d. The differences of cardiovascular ischemia and hemorrhage rate 12 months after PCI, and test the thrombelastogram (reaction time, clotting time, solidification angle, amplitude peak) and drug effects (aspirin inhibition and clopidogrel inhibition) were compared between the two groups. Results The incidence rate of cardiovascular ischemia in 12 months after PCI operation in the large dose group (31.15% ) was lower than that in th low dose group (62.30%), and the incidence of rebleeding was much higher than that of low dose group (24.59% vs. 4.92%), and the differences were statistically significant (P<0.05). There was no significant difference in the solidification angle between the two groups (P>0.05). The amplitude peak of the large dosegroup was lower, and the coagulation and reaction time of the large dose group were higher (P<0.05). There was no significant difference in the aspirin inhibition between the two groups (P>0.05). Compared with the small dose group, the clopidogrel inhibition rate of large dose group was higher (P< 0.05). Conclusion The dose of 100 mg/d clopidogrel after PCI can effectively prevent cardiovascular ischemic events in elderly patient, but attention should be paid for the risk of increasing bleeding events.

参考文献/References:

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备注/Memo

备注/Memo:

作者简介：李帅，硕士，主治医师，研究方向：心脏重症与康复 通信作者：李帅，E-mail：71178227@qq.com

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更新日期/Last Update: 2017-04-18