CAJ | 학술논문

目的评估老年冠心病患者经皮冠状动脉介入治疗（PCI）后联合使用质子泵抑制剂（PPI）及氯吡咯雷是否安全、有效。方法回顾本院PCI术后并有复查冠状动脉造影的老年患者（≥60岁），共317例，并根据联合使用PPI情况，分无PPI组（69例），PPI低暴露组（142例）及PPI高暴露组（106例），观察各组支架内再狭窄率及临床事件。结果平均随访时间为（14±6.5）个月，PPI高暴露组支架内再狭窄率比无PPI组显著增加（P＜0.05），总的临床不良事件无显著性差异（P＞0.05）。PPI低暴露组支架内再狭窄及心血管事件增加无显著性差异（P＞0.05），出血事件明显减少（P＜0.05）。结论对老年患者PCI术后长期使用PPI可增加支架内再狭窄及心血管风险，但总体是安全的，短期使用则更加安全有效。
목적평고노년관심병환자경피관상동맥개입치료（PCI）후연합사용질자빙억제제（PPI）급록필각뢰시부안전、유효。방법회고본원PCI술후병유복사관상동맥조영적노년환자（≥60세），공317례，병근거연합사용PPI정황，분무PPI조（69례），PPI저폭로조（142례）급PPI고폭로조（106례），관찰각조지가내재협착솔급림상사건。결과평균수방시간위（14±6.5）개월，PPI고폭로조지가내재협착솔비무PPI조현저증가（P＜0.05），총적림상불량사건무현저성차이（P＞0.05）。PPI저폭로조지가내재협착급심혈관사건증가무현저성차이（P＞0.05），출혈사건명현감소（P＜0.05）。결론대노년환자PCI술후장기사용PPI가증가지가내재협착급심혈관풍험，단총체시안전적，단기사용칙경가안전유효。
Objective Assessment in adhibiting clopidogrel and PPI combinedly after PCI in elderly patients with coronary heart disease. Method Retrospecting Post-PCI for the elderly patients (age≥60) with reviewing coronary angiography (n = 317), looking into in-stent restenosis (ISR) and clinical events in the group controlling (n=69), low exposure group of PPI (n=142) and high exposure group of PPI (n=106). Result Average follow-up time:(14±6.5) months increasing signiifcantly in ISR of high exposure group of PPI outweigh control group(P < 0.05), there isn’t signiifcant difference in general clinical adverse events (P>0.05). It is assumed that signiifcant difference of ISR and vascular events increasing didn’t occur betweem in control and low exposure group of PPI (P>0.05), while we can see bleeding events signiifcantly reduced (P<0.05). Conclusion Although long term usage of PPI in Post-PCI for the elderly patients would increase the possibility of ISR and residual cardiovascular risk, overall is safe and more safe and effective in short-term usage.