【摘要】 目的通过对接受双联抗血小板聚集药物治疗的冠脉支架术后患者资料进行回顾性分析,明确消化道出血的相关危险因素。方法 960例冠脉支架植入术后服用双联抗血小板药物患者,通过电话或门诊随访方式收集患者资料,以是否出现消化道出血为因变量(是=1,否=0),以年龄(≥65岁=1;<65岁=0)、性别(男=1,女=0)以及吸烟史、服用华法林、肌酐清除率下降、联用质子泵抑制剂(PPI)、饮酒史、消化道疾病病史、糖尿病病史、左室射血分数下降(有=1,无=0)等为自变量进行多因素回归分析。结果 960例冠脉支架植入术后服用双联抗血小板药物患者中有46例(4.79%)出现消化道出血事件,分析显示:老年(≥65岁)、有吸烟史、服用华法林、肌酐清除率下降、有饮酒史、有消化道疾病病史、左室射血分数下降为冠脉支架植入术后接受双联抗血小板聚集药物治疗患者消化道出血的危险因素(P<0.05),而联用PPI为冠脉支架植入术后接受双联抗血小板聚集药物治疗患者消化道出血的保护因素(P<0.05)。结论双联抗血小板聚集药物治疗的冠脉支架术后患者消化道出血高危因素包括老年(≥65岁)、有吸烟史、服用华法林、肌酐清除率下降、有饮酒史、有消化道疾病病史、左室射血分数下降等。更多还原

【Abstract】 Objective To clarify related risk factors for alimentary tract hemorrhage by retrospectively analyzing clinical data of patients treated by dual antiplatelet drugs after coronary stent operation. Methods There were 960 coronary stent operation patients treated with dual antiplatelet drugs after operation, and their clinical data were collected by telephone or outpatient follow-up. Multivariate regression analysis was taken along with whether alimentary tract hemorrhage or not as dependent variable(with=1, without=0) and age( ≥ 65 years old=1, <65 years old=0), gender(male=1, female=0), smoking history, warfarin administration, reduced creatinine clearance rate, proton pump inhibitor(PPI) combination, alcohol intaking history, alimentary tract disease history, diabetes history and reduced left ventricular ejection fraction(with=1, without=0) as independent variables. Results Among 960 patients treated by dual antiplatelet drugs after coronary stent operation, there were 46 cases(4.79%) with alimentary tract hemorrhage. Analysis showed elder age(≥65 years old), smoking history, warfarin administration, reduced creatinine clearance rate, alcohol intaking history, alimentary tract disease history, and reduced left ventricular ejection fraction as risk factors for alimentary tract hemorrhage in patients treated by dual antiplatelet drugs after coronary stent operation(P<0.05), while PPI combination was shown as protective factor for alimentary tract hemorrhage in patients treated by dual antiplatelet drugs after coronary stent operation(P<0.05). Conclusion High risk factors for alimentary tract hemorrhage in patients treated by dual antiplatelet drugs after coronary stent operation include elder age( ≥ 65 years old), smoking history, warfarin administration, reduced creatinine clearance rate, alcohol intaking history, alimentary tract disease history, and reduced left ventricular ejection fraction.更多还原