阿司匹林联合小剂量替罗非班预防冠心病PCI术后血栓形成的效果评价

Evaluation of aspirin combined with low-dose tirofiban for the prevention of thrombosis after PCI for coronary heart disease

目的探讨阿司匹林联合小剂量替罗非班预防冠心病经皮冠状动脉介入治疗(PCI)术后血栓形成的效果。方法500例冠心病行PCI术治疗患者为研究对象,随机分为观察组与对照组,各250例。对照组采用氯吡格雷联合阿司匹林治疗,观察组采用阿司匹林联合小剂量替罗非班治疗。比较两组术后血栓、出血及血小板减少症发生情况,治疗前后心功能指标[左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)]变化情况。结果观察组术后血栓发生率2.80%低于对照组的11.20%,差异有统计学意义(P<0.05)。观察组术后血小板减少症发生率13.20%略高于对照组的11.60%,但差异无统计学意义(P>0.05)。观察组术后轻度出血22例,中度出血7例,出血率为11.60%(29/250);对照组术后轻度出血20例,重度出血6例,出血率为10.40%(26/250)。两组术后出血率比较差异无统计学意义(P>0.05)。治疗后,观察组LVEDD(47.15±2.07)mm、LVESD(34.98±1.94)mm与对照组LVEDD(47.13±2.08)mm、LVESD(34.70±2.03)mm均小于本组治疗前的(50.28±2.66)、(35.88±1.03)mm和(50.29±2.70)、(35.84±1.19)mm,观察组LVEF(50.98±1.93)%与对照组LVEF(50.76±1.88)%均高于本组治疗前的(45.09±1.28)%、(45.11±1.26)%,差异均有统计学意义(P<0.05)。治疗后,两组LVEF、LVEDD、LVESD比较,差异无统计学意义(P>0.05)。结论阿司匹林联合小剂量替罗非班对冠心病患者行PCI术治疗有积极作用,可有效预防术后血栓形成,值得临床推广应用。

Objective To discuss the effect of aspirin combined with low-dose tirofiban for the prevention of thrombosis after percutaneous coronary intervention(PCI)for coronary heart disease.Methods A total of 500 patients treated with PCI for coronary artery disease were studied and randomly divided into observation group and control group,with 250 cases in each group.The control group was treated with clopidogrel and aspirin,and the observation group was treated with aspirin and low-dose tirofiban.Both groups were compared in terms of incidence of postoperative thrombosis,bleeding and thrombocytopenia,and the changes of cardiac function indexes[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD)]before and after treatment.Results The incidence of postoperative thrombosis in the observation group was 2.80%,which was lower than 11.20%in the control group,and the difference was statistically significant(P<0.05).The incidence of postoperative thrombocytopenia 13.20%in the observation group was slightly higher than 11.60%in the control group,but the difference was not statistically significant(P>0.05).Postoperatively,the observation group had 22 cases of mild bleeding and 7 cases of moderate bleeding,with a bleeding rate of 11.60%(29/250).The control group had 20 cases of mild bleeding and 6 cases of severe bleeding,with a bleeding rate of 10.40%(26/250).There was no statistically significant difference in the postoperative bleeding rate between the two groups(P>0.05).After treatment,the LVEDD and LVESD were(47.15±2.07)and(34.98±1.94)mm in the observation group,and(47.13±2.08)and LVESD(34.70±2.03)mm in the control group,which were less than(50.28±2.66),(35.88±1.03)mm and(50.29±2.70),(35.84±1.19)mm before treatment in this group;the LVEF was(50.98±1.93)%in the observation group and(50.76±1.88)%in the control group,which were higher than(45.09±1.28)%and(45.11±1.26)%before treatment in this group;the differences were all statistically significant(P<0.05).After treatment,there was no statistically significant difference in LVEF,LVEDD,and LVESD between the two groups(P>0.05).Conclusion Aspirin combined with low-dose tirofiban has a positive effect in patients treated with PCI for coronary artery disease,which can effectively prevent postoperative thrombosis and is worthy of clinical promotion and application.