急性冠脉综合征合并消化道出血抗栓治疗的临床研究

Clinical Study on Antithrombotic Therapy for Acute Coronary Syndrome Complicated with Gastrointestinal Bleeding

目的探讨急性冠脉综合征(ACS)合并消化道出血患者采用抗栓治疗的临床疗效。方法选取2015年7月至2018年3月我院收治的ACS合并消化道出血患者60例为研究对象。患者在入院时给予双联抗血小板治疗,若消化道出血较为严重,则停用阿司匹林,采用西洛他唑胶囊+奥美拉唑钠治疗。观察临床疗效,检测患者治疗前后的血清血红蛋白(Hgb)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)水平,采用SF-36评价患者治疗前后的生活质量。结果60例患者的治疗总有效率为81.67%。治疗后,患者的血清Hgb水平与治疗前相比无显著变化(P>0.05),而CK、CK-MB水平均显著低于治疗前(P<0.05)。治疗后,患者的躯体功能、生理功能、躯体疼痛、社会功能、总体健康、情感功能、精神健康评分均显著高于治疗前(P<0.05)。终点事件发生率为6.67%。结论急性冠脉综合征合并消化道出血患者进行抗栓治疗可有效提高临床疗效,改善生活质量。

Objective To explore the clinical efficacy of antithrombotic therapy for patients with acute coronary syndrome(ACS)complicated with gastrointestinal bleeding.%Methods 60 patients with ACS complicated with gastrointestinal bleeding admitted to our hospital from July 2015 to March 2018 were selected as research objects.Patients were given dual antiplatelet therapy at admission.If gastrointestinal bleeding was severe,aspirin was discontinued,and cilostazol capsule+omeprazole sodium were used for treatment.The clinical efficacy was observed.The levels of serum hemoglobin(Hgb),creatine kinase(CK),and creatine kinase isoenzyme(CK-MB)before and after treatment were detected.SF-36 was used to evaluate the quality of life of patients before and after treatment.%Results The total effective rate of treatment in 60 patients was 81.67%.After treatment,patients’serum Hgb level had no significant change compared with that before treatment(P>0.05),while the levels of CK and CK-MB were significantly lower than those before treatment(P<0.05).After treatment,patients’physical function,physiological function,physical pain,social function,overall health,emotional function,and mental health scores were significantly higher than those before treatment(P<0.05).The incidence of end events was 6.67%.%Conclusions Antithrombotic therapy can effectively improve the clinical efficacy and quality of life of patients with ACS complicated with gastrointestinal bleeding.