支架植入术后缺血事件和双联抗血小板治疗后出血事件风险评估的研究进展

Advances in Risk Assessment of Post-stenting Ischemic and Bleeding Events Caused by Dual Antiplatelet Therapy

随着我国冠状动脉粥样硬化性心脏病患病人数的迅速增长和介入治疗技术的不断改良,越来越多的患者接受了药物洗脱支架植入术.双联抗血小板治疗可以降低术后支架内血栓形成发生风险,同时也增加了出血事件的发生风险.相关指南建议医生个性化制定双联抗血小板治疗疗程.日常治疗决策过程中,制定特定患者双联抗血小板治疗最佳疗程前需对其出血事件和缺血事件发生风险进行评估.近年来,不断有学者对支架植入术后接受双联抗血小板治疗患者的临床特征进行汇总分析,基于分析结果开发支架植入术后缺血事件和双联抗血小板治疗出血事件发生风险评估工具.本文主要就已发表的高质量风险评估工具进行综述,旨在为临床医生的后期应用与研究提供帮助.

The number of patients with coronary atherosclerotic heart disease in China is increasing rapidly.As interventional techniques continue to be improved,the application of drug-eluting stent placement in this group is becoming wider.Dual antiplatelet therapy(DAPT) reduces the risk of postoperative stent thrombosis,but increases the risk of bleeding. Related guidelines recommend that doctors develop personalized DAPT regimens,and perform an assessment of the risks of bleeding and ischemic events prior to develop the optimal DAPT regimen for a patient.In recent years,there has been a continuous analysis of the clinical features of patients receiving DAPT after stent implantation,and based on the results,risk assessment tools for ischemic events after stent implantation and bleeding events caused by DAPT have been developed.This article reviews the published high-quality risk assessment tools to provide help for further clinical application and research of such tools.