高龄冠心病患者药物支架植入术后双联抗血小板治疗的出血并发症分析

被引:16
作者
方华 [1 ]
张高峰 [2 ]
许澎 [2 ]
乔祺 [2 ]
机构
[1] 上海市闵行区古美社区卫生中心
[2] 上海市第五人民医院心内科
关键词
冠心病; 经皮冠状动脉介入; 双重抗血小板; 出血;
D O I
暂无
中图分类号
R541.4 [冠状动脉(粥样)硬化性心脏病(冠心病)];
学科分类号
100201 [内科学];
摘要
目的评价年龄对冠心病药患者物支架植入术后双重抗血小板治疗的出血影响。方法将575例因急性冠脉综合征植入药物支架进行双重抗血小板治疗(阿司匹林+氯比格雷)的患者,分成高龄组(70岁及以上,共224例)及低龄组(70岁以下,共351例),随访6~54个月,比较两组出血发生率、出血相关死亡的发生情况。结果高龄组与低龄组中出血事件包括消化道出血11例vs 6例,血尿9例vs 6例,脑出血1例vs 2例,因出血死亡2例vs 1例。高龄组消化道出血更常见(P<0.05)。两组手术住院期间出血事件均占整个出血事件的大多数(18/21 vs 11/14),未发生严重出血。院外出血3例(2例vs 1例),均死亡。结论冠心病植入药物支架后双重抗血小板治疗在高龄患者中出血并发症较多见,大多发生在住院期间。定期随访大便隐血可以及时发现轻微出血,避免病情进展;严重出血者预后不佳。
引用
收藏
页码:245 / 247
页数:3
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