摘要
目的观察经皮冠脉内介入术(percutaneous coronary intervention,PCI)后使用西洛他唑对阿司匹林致上消化道出血患者的外周血血小板聚集率、PGE2及心血管事件发生率的影响。方法 64例确诊冠心病并行PCI术后的患者,服用阿司匹林和氯吡格雷双重抗血小板治疗出现阿司匹林相关上消化道出血,其中32例患者改用西洛他唑加氯吡格雷,而另外32例患者出血治疗后继续原抗血小板治疗方案,随访比较两组患者血小板聚集率、PGE2及心血管事件发生率。结果平均随访(0.9±0.1)年,两组患者血小板聚集率均明显下降,西洛他唑组的血小板聚集率显著低于阿司匹林组(P<0.05),外周血PGE2的浓度高于阿司匹林组(P<0.05),但两组患者临床不良事件发生率差异无统计意义。结论对PCI术后上消化道出血患者,应用西洛他唑替代阿司匹林,联用氯吡格雷进行抗血小板治疗,经过短期的临床观察,其血小板聚集率优于阿司匹林,升高外周血PGE2的浓度,且安全性与阿司匹林相当,可用于预防上消化道出血的复发。
Objective To observe the effect of cilostazol combined with clopidogrel therapy in patients diagnosed aspirin-associated upper gastrointestinal bleeding after percutaneous coronary intervention（PCI） on the peripheral blood platelet aggregation rate,PGE2 and incidence rate of cardiovascular events.Methods 64 diagnosed coronary heart disease patients are recruited after PCI with drug-eluting stents implanted,all of whom received aspirin and clopidogrel dual antiplatelet therapy.After developed aspirin-associated upper gastrointestinal bleeding,32 patients accepted the alternative cilostazol and clopidogrel therapy and the other 32 pateints continued to receive the dual anti-platelet therapy after bleeding be treated.Platelet aggregation rate,PGE2 and the incidence of cardiovascular events were evaluated in the two groups after follow-up.Results After average 0.9±0.1 years＇ follow-up,platelet aggregation rate were significantly decreased in two groups,and it was lower in cilostazol group than that of aspirin group（P0.05）,with higher concentrations of PGE2 in peripheral blood in cilostazol treatment group（P0.05）.However,there were no statistically differences in the incidences rate of clinical cardiovascular adverse events in both groups.Conclusion After a short-term clinical follow-up,the combinations of cilostazol and clopidogrel therapy in patients with aspirin-associated upper gastrointestinal bleeding after PCI have a lower platelet aggregation rate,higher peripheral blood PGE2 concentrations and equivalent safety compared with aspirin and clopidogrel dual antiplatelet therapy,it can be applied to prevent recurrence of upper gastrointestinal bleeding.
出处
《中国实用医药》
2011年第36期25-27,共3页
China Practical Medicine
关键词
冠状动脉疾病
西洛他唑
阿司匹林
血小板聚集率
经皮冠脉介入治疗
Coronary artery disease
Cilostazol
Aspirin
Platelet aggregation rate
Percutaneous coronary intervention
