首页|PCI术后出血的危险因素及CRUSADE评分与出血发生率的相关性

PCI术后出血的危险因素及CRUSADE评分与出血发生率的相关性

Risk factors for bleeding after PCI and correlation between CRUSADE score and incidence of bleeding/

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目的:探究经皮冠状动脉介入治疗(PCI)术后出血的危险因素及CRUSADE评分与出血发生率的相关性.方法:选择2020年3月~2021年3月在华北医疗健康集团峰峰总医院行PCI术的130例冠心病(CHD)患者,采用CRUSADE评分系统对患者术后出血风险进行评估,根据评分结果将所有患者分为低中危组(n=84)和高危组(n=46);给予高危组阿司匹林肠溶片+氯吡格雷+雷贝拉唑治疗,低中危组阿司匹林肠溶片+氯吡格雷治疗.比较两组一般资料、术后出血情况;根据PCI术后是否出血,所有患者被分为出血组(38例)和未出血组(92例).采用多因素Logistic回归分析PCI术后出血的影响因素;采用Spearman分析CRUSADE评分与PCI术后出血发生率的相关性.结果:高危组术后出血总发生率显著高于低中危组(P<0.001).与未出血组比较,出血组年龄明显较大,肌酐清除率显著降低,心率、收缩压、舒张压、高血压和糖尿病史以及CRUSADE高危比例均显著增加(P均<0.01).多因素Logistic回归分析结果显示,年龄、合并高血压以及CRUSADE高危是PCI患者术后出血的独立危险因素(OR=6.231、8.954、2.453,P<0.05或<0.01),肌酐清除率是其的独立保护因素(OR=0.005,P<0.001).Spearman相关分析显示,CRUSADE评分与PCI术后出血发生率呈正相关(r=0.352,P=0.013).结论:高龄、合并高血压以及CRUSADE高危的CHD患者PCI术后出血风险高,临床上应用CRU-SADE 系统评价,可有效提升术后出血预测效能,尽早给予患者药物干预,保证患者预后.
Objective:This study aims to investigate risk factors for bleeding after percutaneous coronary intervention(PCI)and correlation between CRUSADE score and incidence of bleeding.Methods:A total of 130 patients with coronary heart disease(CHD)underwent PCI in Fengfeng General Hospital of North China Medical and Health Group between March 2020 and March 2021 were selected.Bleeding risk after PCI was assessed by CRUSADE scoring system,according to the results,patients were divided into low-medium risk group(n=84,aspirin enteric-coated tablet+clopidogrel therapy)and high risk group(n=46,aspirin enteric-coated tablet+clopidogrel+rabeprazole therapy).General data and bleeding after PCI were compared between two groups;according to presence of bleeding after PCI,patients were divided into bleeding group(n=38)and no bleeding group(n=92).Multivariate Logistic regression was used to analyze influencing factors of bleeding after PCI;Spearman method was used to analyze the correlation between CRUSADE score and incidence of bleeding after PCI.Results:Total incidence of bleeding after PCI in high risk group was significantly higher than that of low-medium risk group(P<0.001).Compared with patients in no bleeding group,those in bleeding group had significant higher age,heart rate,systolic blood pressure,diastolic blood pressure,proportions of hypertension,diabetes and CRUSEDE high-risk,and significant lower creatinine clearance rate(P<0.01 all).Multivariate Logistic regression showed that age,hypertension and CRUSADE high-risk were independent risk factors for bleeding after PCI(OR=6.231,8.954,2.453,P<0.05 or<0.01),while creatinine clearance rate was its independent protective factor(OR=0.005,P<0.001).Spearman correlation analysis indicated that CRUSADE score was positively correlated with incidence of bleeding after PCI(r=0.352,P=0.013).Conclusion:Advanced age,hypertensive and CRUSADE high-risk CHD patients after PCI have high risk of bleeding.CRUSADE system assessment can effectively increase predictive efficacy for bleeding after PCI so as to provide early medication and ensure prognosis.

Angioplasty,balloon,coronaryRisk factorsPostoperative hemorrhage

张亚敏、翟晓、杨静、李锐、孟利敏

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华北医疗健康集团峰峰总医院内二科,河北邯郸 056200

华北医疗健康集团峰峰总医院放射科,河北邯郸 056200

邯郸市第一医院心脏大血管外科

血管成形术,气囊,冠状动脉 危险因素 手术后出血

2024

心血管康复医学杂志
福建省康复医学会 中国康复医学会

心血管康复医学杂志

CSTPCD
影响因子:1.157
ISSN:1008-0074
年,卷(期):2024.33(6)