ACS合并糖尿病患者药物涂层支架术后应用新型三联抗血小板治疗的长期疗效

Long-term therapeutic effect of new triple antiplatelet therapy on patients with ACS complicated diabetes mellitus after drug-eluting stenting

目的:探讨新型三联抗血小板治疗急性冠状动脉综合征(ACS)合并糖尿病(DM)患者药物涂层支架术后的长期疗效。方法:收集245名在我院进行经皮冠状动脉介入治疗的ACS合并DM患者资料,按照手术后不同治疗方案分为:二联抗血小板组(124例,阿司匹林和氯吡格雷联合治疗)和三联抗血小板组(121例,阿司匹林,氯吡格雷和西洛他唑联合治疗),1年后对两组治疗的远期效果进行比较。结果:1年后,三联抗血小板组主要不良心脏事件发生率明显低于二联抗血小板组(8.3%比17.7%,P=0.028);两组患者支架内血管再狭窄和不良反应发生率均无显著差异(P均>0.05),且均没有出现严重的出血事件。结论:急性冠脉综合征合并糖尿病患者行药物涂层支架手术后采用阿司匹林,氯吡格雷和西洛他唑的三联抗血小板治疗,可显著降低主要不良心脏事件发生率,并且与采用阿司匹林,氯吡格雷的二联抗血小板治疗方案相比,并未增加药物不良反应发生率,值得推广。

Objective：To explore long-term therapeutic effect of new triple antiplatelet therapy on patients with acute coronary syndrome（ACS）complicated diabetes mellitus（DM）after drug-eluting stenting.Methods：Data of 245 ACS＋ DM patients who received percutaneous coronary intervention in our hospital were collected.According postoperative therapeutic plan,they were divided into dual antiplatelet group（n=124,received aspirin combined clopidogrel）and triple antiplatelet group（n=121,received aspirin,clopidogrel combined cilostazol）.Long-term therapeutic effect was compared between two groups after one year.Results：After one year,incidence rate of major adverse cardiovascular events in triple antiplatelet group was significantly lower than that of dual antiplatelet group（8.3% vs.17.7%,P=0.028）.There were no significant difference in incidence rates of in-stent restenosis and adverse reactions between two groups（P〉0.05 both）,and no severe hemorrhage events were found in two groups.Conclusion：Triple antiplatelet therapy of aspirin,clopidogrel and cilostazol can significantly reduce incidence rate of MACE in ACS＋ DM patients after drug-eluting stenting.Compared with dual antiplatelet therapy of aspirin and clopidogrel,it doesn＇t increase incidence rate of adverse drug reactions,which is worth extending.