摘要
目的评价PCI术后口服西洛他唑、阿司匹林、氯吡格雷三联抗血小板治疗的有效性和安全性。方法筛选成功行PCI术的冠心病患者150例，随机分成对照组（75例）和试验组（75例）。对照组至少于术后当日开始接受标准的阿司匹林和氯吡格雷两联抗血小板治疗，试验组亦至少于术后当日开始接受西洛他唑、阿司匹林和氯吡格雷三联抗血小板治疗。记录患者术后6个月主要心脏不良事件的发生及出血情况，采用血栓弹力图检测血小板聚集功能及药物抑制率。结果对照组、试验组术后6个月的主要心脏不良事件发生率分别为6．7％（5／75）和4．0％（3／75），试验组低于对照组，但差异无统计学意义（P=0．467）；出血率分别为10．6％（8／75）和14。67％（11／75），两组差异无统计学意义（P=-o．461）；两组术后6个月再次检测血栓弹力图，试验组结果更为理想，其MA值较对照组偏低，AA％、ADP％较对照组偏高，两组MA值、AA％、ADP％差异有统计学意义（P值均〈0．05）。结论PCI术后口服西洛他唑、阿司匹林和氯吡格雷三联抗血小板治疗不增加出血事件且可降低血小板聚集活性，提示三联抗血小板治疗可能有助于降低血栓发生风险。
Objective The purpose of this study was to evaluate the effectiveness and safety of cilostazol, aspirin and clopidogrel-combined antiplatelet therapy after PCI. Methods 150 patients with coronary heart disease were selected from those undergone PCI operation. Then they were randomly divided into two groups： control group with 75 patients and experimental group with the rest 75 patients. At the same day of PCI, the patients in control group began to take aspirin and clopidogrel antithrombotic therapy while the patients in experimentalgroup start to take eilostazol, aspirin and clopidogrel. Finally, the major heart accidents and bleeding situation were documented, and the thromboelastography was adopted to accumulate platelet and detect medicine inhibition ratio in 6 months after PCI. Results The major accident rates for control group and experimental group in the 6 months after PCI were respectively 6.7%（5/75） and 4.0%（3/75） and the rate of experimental group was a little bit lower than that of control group, which makes no difference in statistics （P=0.467）, the bleeding rates for two groups were correspondingly 10.6%（8/75） and 14.67%（11/75）, which had no difference in statistics （P=0.461）. 6 months later, the thrombelastograph was employed again for detection, and the outcome of experimental was more ideal considering its lower MA and higher AA% and ADP% compared with those values of control group. The MA, AA% and ADP% had differences in statistics （P〈0.05）. Conclusion Cilostazol, aspirin and chlorine-com- bined therapy after PCI does not increase bleeding events and can reduce platelet aggregation activity, indicating that the triple antiplatelet therapy may help reduce the risk of thrombosis occurs.
出处
《中国心血管病研究》
CAS
2013年第7期493-496,共4页
Chinese Journal of Cardiovascular Research
