摘要
目的探讨冠状动脉粥样硬化性心脏病(冠心病)患者经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗后长期接受单一抗血小板治疗的消化道损伤情况与药物依从性。方法纳入2017年1月到2019年12月在10家研究中心确诊为冠心病并接受PCI治疗后1~1.5年并接受单一抗血小板治疗(阿司匹林、铝镁匹林或氯吡格雷)的患者为研究人群,按照服用抗血小板药物情况分为3组。通过胃肠道症状等级评估量表(gastrointestinal symptom rating scale,GSRS)评分问卷判定消化道损伤情况,药物依从性问卷(medication adherence questionnaire,MAQ)评估药物依从性。GSRS评分≥2分为主要研究终点,MAQ评分>0分为次要研究终点。采用倾向性评分对基线数据进行匹配分析,多元Logistics回归模型分析抗血小板药物终点事件发生情况。结果共纳入研究对象753例,阿司匹林组有276例(61%)发生消化道损伤,铝镁匹林组58例(42%),氯吡格雷组93例(58%)。以阿司匹林组作为对照组,铝镁匹林组主要研究终点事件发生显著低于阿司匹林组[OR=0.47(95%CI:0.31~0.71)],对协变量进行校正后仍有显著差异[OR=0.47(95%CI:0.23~0.92)];但铝镁匹林组与阿司匹林组研究对象次要终点事件差异无统计学意义[OR=0.5(95%CI:0.24~1.04)]。结论冠心病患者PCI治疗后单一抗血小板治疗服用铝镁匹林与更低的消化道损伤相关。
Objectives To determine the digestive tract injury and drug adherence in patients with coronary heart disease receiving long-term mono-antiplatelet therapy after percutaneous coronary intervention(PCI).Methods Patients diagnosed with coronary heart disease after accepting PCI between 1-1.5 years in 10 study centers from January 2017 to December 2019 who received mono-antiplatelet therapy(aspirin or aluminum magnesium aspirin or clopidogrel),were included as the study population and divided into three groups based on antitablet medication.Gastrointestinal injury was determined by the gastrointestinal symptom rating scale(GSRS)score questionnaire,and the medication adherence questionnaire(MAQ)was used to assessed drug adherence.A GSRS score greater than or equal to 2 was classified as primary study endpoints,and a MAQ score greater than 0 was classified as secondary study endpoints.Propensity score matching was used to match the baseline data and the multiple Logistics regression model was used to analyze the occurrence of the endpoint events.Results A total of 753 patients were included,including 276(61%)in aspirin group,58(42%)in aluminum magnesium aspirin group and 93(58%)in clopidogrel group.With the aspirin group as control group,the main study endpoint event in aluminum magnesium aspirin group was significantly lower than that in aspirin group[OR=0.47(95%CI:0.31-0.71)],and after correction for covariates was still significantly different[OR=0.47(95%CI:0.23-0.92)].However,there was no significant difference in the secondary endpoint events between aspirin group and aluminum magnesium aspirin group,with OR=0.5(95%CI:0.24-1.04).Conclusions Lower digestive tract injury of monoantiplatelet therapy in patients with coronary heart disease after PCI is associated with aluminum magnesium aspirin.
作者
林夏怡
刘津
郭照东
黄浩樟
邓静茹
梁国潇
刘勇
谭宁
LIN Xiayi;LIU Jin;GUO Zhaodong;HUANG Haozhang;DENG Jingru;LIANG Guoxiao;LIU Yong;TAN Ning(School of Medicine,South China University of Technology,Guangzhou 510006,China;Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention,Guangdong Provincial People′s Hospital(Guangdong Academy of Medical Sciences),Southern Medical University,Guangzhou 510100,China;Department of Cardiology,Guangdong Cardiovascular Institute,Guangdong Provincial People′s Hospital(Guangdong Academy of Medical Sciences),Southern Medical University,Guangzhou 510000,China;Department of General Practice,Guangdong Provincial People′s Hospital(Guangdong Academy of Medical Sciences),Southern Medical University,Guangzhou 510000,China;The Second School of Clinical Medicine,Southern Medical University,Guangzhou 510515,China;Department of Cardiology,Shenzhen People′s Hospital,Shenzhen,Guangdong 518020,China)
出处
《岭南心血管病杂志》
CAS
2023年第3期242-249,共8页
South China Journal of Cardiovascular Diseases
基金
广东省临床用药研究基金(项目编号:2019ZX01)
广东省自然科技项目(项目编号:2020B1111170011,KJ022021049)。
关键词
冠状动脉疾病
抗血小板
消化道损伤
药物依从性
coronary heart disease
antiplatelet
digestive tract injury
drug adherence
