不同抗凝药物对冠状动脉旁路移植术后患者桥血管通畅程度及安全性的影响

Effects of Different Anticoagulant Drugs on Patency and Safety of Bridge Vessels in Patients after Coronary Artery Bypass Grafting

目的比较阿司匹林肠溶片、硫酸氢氯吡咯雷片、替格瑞洛对冠状动脉旁路移植术(CABG)后患者桥血管通畅程度及安全性的影响。方法将150例行CABG术患者按照随机数字表法分为A、B、C 3组,每组50例。3组患者术后给予不同药物抗凝治疗,A组给予阿司匹林肠溶片,B组给予硫酸氢氯吡咯雷片,C组给予替格瑞洛,均连续治疗6个月。比较3组患者术后桥血管通畅率、出血事件发生率以及心源性死亡、卒中、靶血管重建、非致命心肌梗死等主要不良心血管事件(MACE)发生率。结果150例患者术中共搭左乳内动脉157根,大隐静脉169根,术后3个月、6个月3组患者动脉、静脉桥血管通畅率比较差异均无统计学意义(P>0.05);治疗后随访1年,3组患者出血事件发生率、MACE发生率比较差异均无统计学意义(P>0.05)。结论阿司匹林肠溶片、硫酸氢氯吡咯雷片以及替格瑞洛对CABG术后患者的桥血管通畅率、出血事件、MACE无显著差异。

Objective To compare the effects of aspirin enteric-coated tablets,clopidogrel bisulfate tablets and ticagrelor on the patency and safety of bridge vessels in patients after coronary artery bypass grafting(CABG).Methods A total of 150 patients were randomly treated with aspirin enteric-coated tablets(group A),clopidogrel bisulfate tablets(group B)or ticagrelor(group C)for 6 months for anticoagulation after CABG,with 50 patients in each group.The rate of postoperative vascular patency and the incidence of bleeding,cardiac death,stroke,target vessel revascularization,non-fatal myocardial infarction and other adverse cardiovascular events(MACE)were compared among the three groups.Results Totally 157 left internal mammary arteries and 169 great saphenous veins were used during operation in the 150 patients.There were no significant differences among the three groups in the patency of bridge vessels 3 and 6 months after operation,as well as in the incidence of bleeding and the incidence of MACE after 1 year of follow-up(P>0.05).Conclusion There are no significant differences in the effects of aspirin enteric-coated tablets,clopidogrel bisulfate tablets and ticagrelor on the patency of bridge vessels and the incidence of bleeding and MACE in patients after CABG.