CHADS-P2A2RC联合BRIC评分在高风险CCS下调MACE事件和减少出血事件的临床应用

Clinical application of MADS-P2A2RC combined with BRIC score in regulating MACE events and reducing bleeding events of high-risk CCS patients

目的 研究CHADS-P2A2RC联合术前急性冠状动脉综合征介入治疗患者出院后出血的危险评分(BRIC-ACS评分)对高风险慢性冠状动脉综合征(CCS)患者经皮冠状动脉介入术(PCI)术后心血管不良事件(MACE事件)和出院后出血(PDB)事件的影响。方法 140例CCS并行PCI治疗的患者,根据CHADS-P2A2RC、BRIC-ACS评分和治疗方案的不同分为对照组[符合CHADS-P2A2RC高危、BRIC-ACS评分中低风险(评分0~39分)]、实验组[符合CHADS-P2A2RC高危、BRIC-ACS评分高风险(评分40~60分)],各70例。对照组采用两种抗血小板药物联合治疗,实验组采用单一抗血小板药物治疗。比较两组MACE、PDB事件发生率。结果 随访第2、4、6个月,实验组的MACE事件发生率分别为2.86%、7.14%、8.57%,均低于对照组的12.86%、20.00%、22.86%,差异有统计学意义(P<0.05)。随访第2、4、6个月,实验组的PDB事件发生率分别为1.43%、4.29%、7.14%,均低于对照组的10.00%、14.29%、18.57%,差异有统计学意义(P<0.05)。结论 CHADS-P2A2RC联合BRIC-ACS评分能有效降低高风险CCS患者PCI术后MACE和PDB事件发生率,对患者的预后改善具有重要意义。

Objective To study the effect of CHADS-P2A2RC combined with preoperative BRIC-ACS score on the major adverse cardiovascular events(MACE)and post-discharge bleeding(PDB)events in patients with high risk of chronic coronary syndrome(CCS)after percutaneous coronary intervention(PCI).Methods All 140 patients with CCS were treated with PCI,and were divided into a control group[CHADS-P2A2RC of high risk and BRIC-ACS score of low to moderate risk(0-39 points)]and an experimental group[CHADS-P2A2RC of high risk and BRIC-ACS score of high risk(40-60 points)]according to the differences of MADs-P2A2RC and BRIC-ACS scores and treatment plans,with 70 cases in each group.The control group was treated with a combination of two antiplatelet agents,and the experimental group was treated with a single antiplatelet agent.The incidences of MACE and PDB were compared between the two groups.Results At 2,4 and 6 months of followup,the incidence of MACE in the experimental group were 2.86%,7.14%and 8.57%,which were lower than those of 12.86%,20.00%and 22.86%in the control group,and the differences were statistically significant(P<0.05).At 2,4 and 6 months of follow-up,the incidence of PDB events in the experimental group were 1.43%,4.29%and 7.14%,which were lower than those of 10.00%,14.29%and 18.57%in the control group,and the differences were statistically significant(P<0.05).Conclusion MADS-P2A2RC combined with BRIC-ACS score can effectively reduce the incidence of MACE and PDB events in high-risk CCS patients after PCI,which is of great significance for improving the prognosis of patients.