摘要
目的分析药物涂层支架置入术患者合并心房颤动(房颤)的三联抗栓治疗的安全性与有效性。方法临床入选168例栓塞风险评分(CHADS2)≥2分,出血风险评分(HAS-BLED)≥3分的药物涂层支架置入术合并房颤患者,随机分为三联抗栓治疗组(A组)、阿司匹林联合氯吡格雷治疗组(B组)以及华法林联合单一抗血小板聚集类药物治疗组(C组),每组各56例。随访2年,比较3组患者治疗的安全性与有效性。结果 A组出血总发生率比B组及C组高(P<0.05),而B组与C组出血总发生率无显著差异(P>0.05)。A组主要心脑血管事件总发生率较B组及C组低(P<0.05),而B组与C组主要心脑血管事件总发生率无显著差异(P>0.05)。结论药物涂层支架植入术合并房颤患者采用三重抗凝治疗,较双重抗血小板或华法林联合单一抗血小板聚集可以更好防治主要心脑血管事件的发生,但具有一定的出血风险。
Objective To analysis of the safety and effectiveness of triple antithrombotic treatment on patients with atrial fibrillation undergoing drug-eluting stent implantation. Methods 168 patients with atrial fibrillation undergoing drug-eluting stent implantation were selected and randomly divided into triple antithrombotic treatment group（ group A） , aspirin combined with clopidogrel group（ group B） ,and warfarin combined with single anti-platelet aggregation group（ group C）with 5 ones in each group. Their embolic risk scores were ≥2 points, and the bleeding risk scores were ≥3 points. The follow-up was made for 2 years, and comparison was made in the treatment safety and effectiveness among the three groups. Results The total incidence of bleeding in group A was higher than those in group B and C（ P 〈 0.05 ）,while there was no significant difference of the incidence between group B and C（P 〉 0.05 ）. The total incidence of cardiac and cerebral events in group A was lower than those in group B and C （ P 〈 0.05 ） , but there was no significant difference in that total incidence between group B and C （ P 〉 0.05 ）. Conclusion Compared with the treatments with double antiplatelet medicine or warfarin combined with single anti-platelet aggregation, the triple antithrombotic therapy on patients with atrial fibrillation undergoing drug-eluting stent implantation can prevent the occurrence of cardiac and cerebral events, but it may increase the bleeding risk.
出处
《西南国防医药》
CAS
2014年第2期173-175,共3页
Medical Journal of National Defending Forces in Southwest China
关键词
冠心病
药物涂层
支架
心房颤动
抗栓
疗效
coronary artery disease
drug-eluting
stent
atrial fibrillation
antithrombotic
curative effect
