摘要
【目的】探讨急性冠状动脉综合征（ACS）患者出血事件发生的相关因素。【方法】选取2005年5月至2015年5月本院确诊为ACS患者753例，按出血事件判别标准将其中发生出血事件的12例，纳入出血组。其余无出血的ACS患者采用分层随机抽样法选取48例纳入无出血组。比较两组患者临床特征、合并症、治疗方法及药物应用。【结果】本研究出血发生率为1．6％（12／753）。与无出血组相比，出血组患者年龄较大，住院天数较长（P〈0.05）。ACS患者合并心功能不全、合并肾功能不全、既往出血史的患者出血率较高（P〈0．05）。使用氯吡格雷、血小板膜蛋白Ⅱb／Ⅲa（GPⅡb／Ⅲa）受体拮抗剂、到上级医院行经皮冠状动脉介入术（PCI）、冠脉搭桥术（CABG）治疗的ACS患者出血率较高（P〈0．05）。【结论】年龄大、合并心功能不全、肾功能不全、既往出血史、行PCI和／或CABG、氯吡格雷、GPⅡb／Ⅲa受体拮抗剂治疗的ACS患者发生出血的可能性较大。
[Objective]To investigate the related factors of hemorrhage events in patients with acute coro- nary syndrome （ACS）.[Methods] Seven hundred and fifty-three cases diagnosed as ACS in our hospital from May 2005 to May 2015 were selected, and 12 of them complicated with hemorrhage were regarded as hemor- rhage group according to the criterion of hemorrhagic events, while 48 of them without hemorrhage were se lected by stratified random sampling method as no hemorrhage group. The clinical features, complications, treatment and drug application of the two groups were compared.[Results]The complicated hemorrhage rate of this research was 1.6% （12/753）. The patients＇ age in the hemorrhage group were older , and their hospital-stay time were longer than those in the no hemorrhage group （ P〈0.05）. Additionally, patients complicated with cardiac insufficiency, renal insufficiency and past history of hemorrhage got higher rate of hemorrhage （ P〈0.05）. ACS patients treated with clopidogrel and platelet membrane protein Ⅱb/Ⅲa（GP Ⅱb/Ⅲa）receptor an tagonist or underwent PCI and （or） CABG in superior hospitals got a higher rate of hemorrhage （ P〈0.05）. [Conclusion] ACS patients with senior age, combined cardiac insufficiency, renal insufficiency, previous histo ry of bleeding, once underwent PCI and / or CABG, or treated with c[opidogrel or GP Ⅱb/Ⅲa receptor an- tagonists are more vulnerable to hemorrhage.
出处
《医学临床研究》
CAS
2016年第7期1285-1287,共3页
Journal of Clinical Research
