不同双重抗血小板治疗时间对急性冠状动脉综合征患者PCI术后预后和安全性的影响

Effect of different dual antiplatelet therapy time on prognosis and safety of patients with ACS after PCI

目的评价不同双重抗血小板治疗时间对急性冠状动脉综合征(ACS)患者经皮冠状动脉介入治疗(PCI)术后预后及安全性的影响。方法将2019年7月至2020年7月于河南省信阳市新县人民医院就诊并行PCI术129例ACS患者纳入研究,将患者随机分为试验组(65例)及对照组(64例),其中试验组患者术后予阿司匹林联合氯吡格雷双重抗血小板治疗1个月,后予氯吡格雷单药抗板治疗5个月;对照组予双抗6个月,并在治疗结束后1年对患者进行随访,记录患者出现的主要心血管不良事件(MACE),并记录患者出现的主要不良反应,分析不同双抗治疗时间对ACS患者预后及安全性的影响。结果通过对两组患者进行为期1年的随访,结果表明两组患者MACE发生率比较,差异无统计学意义(χ^(2)=0.079,P=0.779),但试验组患者的总不良反应发生率低于对照组(χ^(2)=4.293,P=0.038),且试验组患者的累积出血性事件发生率低于对照组(Log-Rankχ^(2)=4.111,P=0.043)。结论PCI术后双抗1个月与术后双抗6个月在术后1年内MACE发生率相似,预后比较,差异无统计学意义,但总不良反应发生率明显降低,且出血不良事件的发生率更低。

【Objective】To evaluate the effect of different dual antiplatelet therapy time on the prognosis and safety of patients with ACS after PCI.【Methods】A total of 129 patients with ACS who underwent PCI in our hospital from July 2019 to July 2020 were enrolled in the study.Patients were randomized into a trial group(65 patients)and a control group(64 patients).Trial group was treated with aspirin combined with clopidogrel dual antiplatelet therapy for 1 month,followed by clopidogrel monotherapy for 5 months;control group was treated with clopidogrel dual antiplatelet therapy for 6 months,and patients were followed up 1 year after treatment.Major Adverse Cardiovascular Events(MACE)occurred in patients,and the main adverse reactions of patients were recorded.The influence of different treatment time on the prognosis and safety of ACS patients was analyzed.【Results】After a one-year follow-up of the two groups of patients,the results showed that there was no significant difference in the incidence of MACE between the two groups(χ^(2)=0.079,P=0.779),but the incidence of total adverse reactions was significantly lower in the trial group than in the control group(χ^(2)=4.293,P=0.038),and the incidence of cumulative hemorrhagic events in the tria group was significantly lower than that in the control group(Log-Rankχ^(2)=4.111,P=0.043).【Conclusion】The incidence of MACE is similar in the 1 month after PCI and 6 months after PCI in the double-antibody after PCI.There is no significant difference in prognosis,but the incidence of total adverse reactions is significantly reduced,and the incidence of adverse bleeding events is more low.