摘要
目的探讨老年急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)后多重用药状态下发生氯吡格雷抵抗(CR)的危险因素。方法回顾性收集2014年1月至2019年12月本院收治的老年AMI接受PCI治疗的患者401例,依据是否出现CR分为CR组122例和非CR组279例,对两组一般情况、患病情况、用药情况和主要实验室检测指标进行比较,筛选出现CR的危险因素。结果多因素logistic回归分析显示,性别、体质量指数、消化性溃疡及应用硝酸甘油、地尔硫卓、胺碘酮、奥美拉唑、埃索美拉唑、西咪替丁是多重用药状态下发生CR的危险因素(OR=2.614、2.437、3.513、3.878、3.751、3.005、3.447、3.111、2.913,均P<0.05)。结论女性、偏胖、患消化性溃疡及应用硝酸甘油、地尔硫卓、胺碘酮、奥美拉唑、埃索美拉唑、西咪替丁的老年AMI患者PCI术后更容易出现CR,抗血小板治疗过程中应定期进行血小板聚集率检测。
Objective To investigate the risk factors of clopidogrel resistance(CR)in elderly patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI)under multiple medications.Methods A total of 401 elderly AMI patients who were treated with PCI in our hospital from January 2014 to December 2019 were retrospectively collected.According to whether there was CR or not,they were divided into 122 cases in CR group and 279 cases in non CR group.The general condition,disease condition,medication condition,and main laboratory test indexes of the two groups were compared,and the risk factors of CR were screened out.Results Multivariate logistic regression analysis showed that sex,body mass index,peptic ulcer,and application of nitroglycerin,diltiazem,amiodarone,omeprazole,esomeprazole,and cimetidine were the risk factors of CR under multiple medications(OR=2.614,2.437,3.513,3.878,3.751,3.005,3.447,3.111,2.913,all P<0.05).Conclusion Elderly AMI patients with female,obesity,peptic ulcer,application of nitroglycerin,diltiazem,amiodarone,omeprazole,esomeprazole,and cimetidine are more likely to have CR after PCI.The platelet aggregation rate should be detected regularly during antiplatelet therapy.
作者
焦婷婷
Jiao Tingting(Shenyang Red Cross Hospital,Shenyang 110013,China)
出处
《国际医药卫生导报》
2020年第23期3628-3631,共4页
International Medicine and Health Guidance News
关键词
急性心肌梗死
介入治疗
多重用药
氯吡格雷抵抗
危险因素
Acute myocardial infarction
Interventional therapy
Multiple medications
Clopidogrel resistance
Risk factors
