论文部分内容阅读
目的:探讨冠心病患者经皮冠状动脉介入治疗(PCI)后1年内,引起上消化道出血(UGH)的主要危险因素。方法:选择行PCI的冠心病患者432例,分析比较1年内发生UGH和未发生UGH患者的临床资料的差异。结果:本组UGH发生率为5.3%(23/432),其中,高龄、急性心肌梗死、既往有消化性溃疡病史、合并慢性支气管炎的患者UGH发生率较高,分别为6.7%、11.5%、9.6%和9.8%,与相应患者比较差异有统计学意义(P<0.05)。术中应用血小板GPⅡb/Ⅲa受体拮抗剂的患者UGH发生率(12.5%)高于未应用血小板GPⅡb/Ⅲa受体拮抗剂的患者(2.7%),差异有统计学意义(P<0.01)。围术期使用和术后1年内间断使用质子泵抑制剂的患者UGH发生率(2.2%)与未使用的患者(13.7%)比较,差异有统计学意义(P<0.05)。结论:高龄、急性心肌梗死、既往有消化性溃疡病史、合并慢性支气管炎增加PCI后UGH的发生,术中应用Ⅱb/Ⅲa受体拮抗剂进一步增加UGH,制酸药物质子泵抑制剂可减小UGH的风险。
Objective: To explore the major risk factors of upper gastrointestinal bleeding (UGH) within one year after percutaneous coronary intervention (PCI) in patients with coronary heart disease. Methods: A total of 432 patients with coronary artery disease (CAD) were enrolled in this study. The clinical data of UGH patients who did not develop UGH within 1 year and their clinical data were analyzed and compared. Results: The prevalence of UGH in this group was 5.3% (23/432). Among them, elderly patients with acute myocardial infarction and previous history of peptic ulcer had a higher incidence of UGH in patients with chronic bronchitis (6.7%, 11.5% , 9.6% and 9.8%, respectively, with statistical significance (P <0.05). The incidence of UGH in patients receiving GPⅡb / Ⅲa receptor antagonist (12.5%) during operation was significantly higher than that of patients without GPⅡb / Ⅲa receptor antagonist (2.7%) (P <0.01). There was a significant difference in the incidence of UGH between perioperative use and discontinuation of proton pump inhibitor (2.2%) and unused patients (13.7%) during the first year after operation (P <0.05). Conclusion: Older age, acute myocardial infarction, past history of peptic ulcer, chronic bronchitis and UGH increase after PCI. Intraoperative application of Ⅱb / Ⅲa receptor antagonist further increases UGH, antacid drug proton pump inhibitor can be reduced UGH risk.