PCI术后应用抗血小板聚集药物致上消化道出血情况及影响因素分析

Analysis of Upper Gastrointestinal Bleeding Caused by Antiplatelet Aggregation Drugs after PCI and Influencing Factors

目的探讨PCI术后应用抗血小板聚集药物致上消化道出血情况及分析其影响因素。方法通过对我院2013年10月-2016年2月心内科行PCI术且应用双联抗血小板治疗的90例患者临床资料做回顾性分析,记录并比较消化道出血组与未出血组患者年龄、性别比例、烟、饮酒史、合并基础病情况、联合用药情况、血小板(PLT)、血红蛋白(Hb)、肌酐(Cr)等血液指标,并对有差异指标做相关性分析。结果年龄≥60岁、有吸烟史、合并高血压、PLT异常、Cr水平上升、Hb降低患者出现上消化道出血的比例大,差异有统计学意义(P<0.05),高龄(≥60岁)、有吸烟史、合并高血压,PLT异常、Cr上升、Hb降低是上消化道出血的独立危险因素。结论 PCI术后应用抗血小板聚集药物致上消化道出血影响因素较多,注重这些因素并提前做出干预,可降低PCI术后应用抗血小板聚集药物引起上消化道出血的危险性。

Objective To investigate the effect of antiplatelet aggregation on upper gastrointestinal bleeding after PCI and its influencing factors. Methods The clinical data of 90 patients who underwent PCI in our hospital between October 2013 and February 2016 was analyzed retrospectively.The age,sex ratio,smoke and alcohol history,combined underlying diseases,combined drug use,PLT,Hb,Cr and other blood parameters were recorded and compared between the upper gastrointestinal bleeding group and non-bleeding group.The correlations between the two groups were analyzed.Results Age ≥60 years old,history of smoking,combination with hypertension,PLT abnormalities,increase of Cr levels and decrease of Hb accounted for a large proportion of cases of upper gastrointestinal bleeding,and the difference was statistically significant（ P 0. 05）. Age（ ≥ 60 years）,history of smoking,combination with hypertension,PLT abnormalities,rise of Cr,and decline of Hb were independent risk factors for upper gastrointestinal bleeding.Conclusion There are many factors that influence upper gastrointestinal bleeding caused by antiplatelet aggregation drugs after PCI.We should pay attention to these factors and take precautions to reduce the risk of upper gastrointestinal bleeding caused by antiplatelet aggregation after PCI.