首页|阿司匹林与氯吡格雷对心脑血管疾病患者上消化道出血风险的影响研究

阿司匹林与氯吡格雷对心脑血管疾病患者上消化道出血风险的影响研究

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目的 探讨阿司匹林和氯吡格雷对心脑血管疾病患者上消化道出血风险的影响.方法 选取杭州市第三人民医院在2015年10月~2016年10月收治的116例发生上消化道出血的心脑血管疾病患者作为研究对象,根据是否应用抗血小板药物分为药物组(n=86)和非药物组(n=30),其中药物组根据用药种类的不同又分为A组(n=30,阿司匹林)、B组(n=24,氯吡格雷)、C组(n=32,阿司匹林氯吡格雷)3组,对比分析各组患者的上消化道出血情况.结果 发生消化道出血前,药物组的腹痛发生率明显比非药物组更低(P<0.05),但2组的腹胀、恶心/呕吐、反酸/嗳气发生率接近,差异不明显.2组患者的消化道出血方式、内镜表现接近,差异不明显,但2组严重消化道出血率分别为47.67%(药物组)和26.67%(非药物组),药物组的严重消化道出血发生率明显更高(P<0.05).A组、B组、C组的严重消化道出血率及出血方式接近,差异不明显.药物组与非药物组患者的消化道出血治疗总有效率分别为96.51%和96.67%,2者接近无明显差异.结论 阿司匹林、氯吡格雷的使用会增加心脑血管疾病患者的上消化道出血风险,但是2者单用或联用并不会对出血程度产生明显影响.
Effects of aspirin and clopidogrel on the risk of upper gastrointestinal bleeding in patients with cardiovascular and cerebrovascular diseases
Objective To investigate the effects of aspirin and clopidogrel on the risk of upper gastrointestinal bleeding in patients with cardiovascular and cerebrovascular diseases. Methods 116 cases of patients with upper gastrointestinal bleeding and cardiovascular disease as research subjects. 86 cases of patients used antiplatelet drugs (drug group), 30 cases didn't use antiplatelet drugs (non-drug group). In the drug group, 30 patients with aspirin alone (group A), 24 patients with clopidogrel alone (group B) and 32 patients with aspirin and clopidogrel (group C) . Compared the upper gastrointestinal bleeding in each group of patients. Results The incidence of abdominal pain in the drug group was significantly lower than non-drug group (P<0.05). However, there was no significant difference in the incidence of bloating, nausea, vomiting, acid reflux compared with non - drug group. There were no significant differences in the endoscopic manifestations of gastrointestinal bleeding between the drug group and the non-drug group. The incidence of severe gastrointestinal bleeding in the drug group was 47.67%, significantly higher than that in the non-drug group (26.67%)(P<0.05). A, B, C three groups of patients with severe gastrointestinal bleeding rate and bleeding patterns were no significant difference. There was no significant difference in the total effective rate of gastrointestinal bleeding between the drug group and the non-drug group. Conclusion Antiplatelet drugs may increase the risk of upper gastrointestinal bleeding in patients with cardiovascular and cerebrovascular diseases, but aspirin and clopidogrel alone or in combination had no significant effect on the degree of gastrointestinal bleeding.

upper gastrointestinal bleedingclopidogrelaspirincardiovascular and cerebrovascular diseases

孔菁、谢晓林、刘路平、马静、胡华伟、张秋实

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杭州市第三人民医院 心血管内科,浙江 杭州 310009

抗血小板药物 阿司匹林 氯吡格雷 心脑血管疾病

2017

中国生化药物杂志
南京生物化学制药研究所,全国生化制药情报中心站,中国生化制药工业协会,中国药品生物制品检定所

中国生化药物杂志

ISSN:1005-1678
年,卷(期):2017.37(10)
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