药物不良反应杂志
藥物不良反應雜誌
약물불량반응잡지
ADVERSE DRUG REACTIONS JOURNAL
2014年
4期
209-212
,共4页
血小板聚集抑制剂%胃肠出血%评价研究
血小闆聚集抑製劑%胃腸齣血%評價研究
혈소판취집억제제%위장출혈%평개연구
Platelet aggregation inhibitors%Gastrointestinal homorrhage%Evaluation studies
目的：探讨CRUSADE评分在抗血小板药物致消化道出血风险评估中的作用。方法1010年9月至1013年9月在浙江省慈溪市第三人民医院内科住院、冠心病诊断明确并入院前一直服用抗血小板药物至少1年的患者纳入本研究，根据是否因服用抗血小板药物而发生消化道出血分为1组，对1组患者进行CRUSADE评分，分析CRUSADE评分与消化道出血的关系。结果共收集到服用抗血小板药物≥1年的冠心病患者787例，发生消化道出血者40例，纳入消化道出血组；应用等距抽样法从余747例患者中随机选出160例纳入无消化道出血组。消化道出血组男性31例，女性9例，年龄45~88（71±9）岁；无消化道出血组男性100例，女性60例，年龄36~89（65±13）岁；1组患者年龄差异有统计学意义（ P﹤0.05）。消化道出血组与无消化道出血组患者中应用阿司匹林肠溶片、硫酸氢氯吡格雷片和两药联用者分别占55%（11/40）、10%（4/40）、35%（14/40）和54%（86/160）、7%（11/160）、39%（63/160），差异无统计学意义（P﹥0.05），有消化道出血和溃疡病史者分别占30.0%（11/40）和11.9%（19/160），差异有统计学意义（ P﹤0.05）。消化道出血组CRUSADE评分为高危与极高危者各11例（各17.5%），无消化道出血组分别为13例（8.1%）和17例（10.6%），差异有统计学意义（ P﹤0.05）。结论 CRUSADE评分有助于判断接受抗血小板治疗的冠心病患者消化道出血风险。建议CRUSADE评分为高危与极高危的冠心病患者应用抗血小板药时联合使用质子泵抑制剂，以预防或减轻消化道出血。
目的：探討CRUSADE評分在抗血小闆藥物緻消化道齣血風險評估中的作用。方法1010年9月至1013年9月在浙江省慈溪市第三人民醫院內科住院、冠心病診斷明確併入院前一直服用抗血小闆藥物至少1年的患者納入本研究，根據是否因服用抗血小闆藥物而髮生消化道齣血分為1組，對1組患者進行CRUSADE評分，分析CRUSADE評分與消化道齣血的關繫。結果共收集到服用抗血小闆藥物≥1年的冠心病患者787例，髮生消化道齣血者40例，納入消化道齣血組；應用等距抽樣法從餘747例患者中隨機選齣160例納入無消化道齣血組。消化道齣血組男性31例，女性9例，年齡45~88（71±9）歲；無消化道齣血組男性100例，女性60例，年齡36~89（65±13）歲；1組患者年齡差異有統計學意義（ P﹤0.05）。消化道齣血組與無消化道齣血組患者中應用阿司匹林腸溶片、硫痠氫氯吡格雷片和兩藥聯用者分彆佔55%（11/40）、10%（4/40）、35%（14/40）和54%（86/160）、7%（11/160）、39%（63/160），差異無統計學意義（P﹥0.05），有消化道齣血和潰瘍病史者分彆佔30.0%（11/40）和11.9%（19/160），差異有統計學意義（ P﹤0.05）。消化道齣血組CRUSADE評分為高危與極高危者各11例（各17.5%），無消化道齣血組分彆為13例（8.1%）和17例（10.6%），差異有統計學意義（ P﹤0.05）。結論 CRUSADE評分有助于判斷接受抗血小闆治療的冠心病患者消化道齣血風險。建議CRUSADE評分為高危與極高危的冠心病患者應用抗血小闆藥時聯閤使用質子泵抑製劑，以預防或減輕消化道齣血。
목적：탐토CRUSADE평분재항혈소판약물치소화도출혈풍험평고중적작용。방법1010년9월지1013년9월재절강성자계시제삼인민의원내과주원、관심병진단명학병입원전일직복용항혈소판약물지소1년적환자납입본연구，근거시부인복용항혈소판약물이발생소화도출혈분위1조，대1조환자진행CRUSADE평분，분석CRUSADE평분여소화도출혈적관계。결과공수집도복용항혈소판약물≥1년적관심병환자787례，발생소화도출혈자40례，납입소화도출혈조；응용등거추양법종여747례환자중수궤선출160례납입무소화도출혈조。소화도출혈조남성31례，녀성9례，년령45~88（71±9）세；무소화도출혈조남성100례，녀성60례，년령36~89（65±13）세；1조환자년령차이유통계학의의（ P﹤0.05）。소화도출혈조여무소화도출혈조환자중응용아사필림장용편、류산경록필격뢰편화량약련용자분별점55%（11/40）、10%（4/40）、35%（14/40）화54%（86/160）、7%（11/160）、39%（63/160），차이무통계학의의（P﹥0.05），유소화도출혈화궤양병사자분별점30.0%（11/40）화11.9%（19/160），차이유통계학의의（ P﹤0.05）。소화도출혈조CRUSADE평분위고위여겁고위자각11례（각17.5%），무소화도출혈조분별위13례（8.1%）화17례（10.6%），차이유통계학의의（ P﹤0.05）。결론 CRUSADE평분유조우판단접수항혈소판치료적관심병환자소화도출혈풍험。건의CRUSADE평분위고위여겁고위적관심병환자응용항혈소판약시연합사용질자빙억제제，이예방혹감경소화도출혈。
Objective To explore the role of CRUSADE score for evaluating the risk of gastrointestinal bleeding due to antiplatelet agents. Methods The hospitalized patients with coronary heart disease and received antiplatelet therapy for more than 1 year before hospitalization in department of internal medicine in the Third People's Hospital of Cixi,Zhejiang Province from September 1010 to September 1013 were enrolled into the study. The patients were divided into the gastrointestinal bleeding group and the non-gastrointestinal bleeding group according to whether gastrointestinal bleeding occurred due to antiplatelet agents. The CRUSADE score was evaluated in the 1 groups and the relationship between the CRUSADE score and gastrointestinal bleeding was analyzed. Results A total of 787 patients with coronary heart disease who received antiplatelet therapy more than 1 year were collected. Forty patients with gastrointestinal bleeding were enrolled into the gastrointestinal bleeding group. One hundred and sixty patients were enrolled into the non-gastrointestinal bleeding group by equidistant sampling method randomly. The gastrointestinal bleeding group comprised 31 male and 9 female with age from 45 to 88( 71 ± 9 ) years. The non-gastrointestinal bleeding group comprised 100 male and 60 female with age from 36 to 89(65 ± 13)years. There was statistically significant difference in age between the 1 groups(P ﹤0. 05). The percentage of cases of receiving aspirin enteric-coated tablets,clopidogrel hydrogen sulfate tablets,and both the above-mentioned drugs in the gastrointestinal bleeding group and the non-gastrointestinal bleeding group were 55%(11/40),10%(4/40),35%(14/40)and 54%(86/160),7%(11/160),39%(63/160),respectively. The difference was not statistically significant(P ﹥0. 05). The percentage of cases who had history of gastroin-testinal bleeding and peptic ulcer in the gastrointestinal bleeding group and the non-gastrointestinal bleeding group were 30. 0%(11/40)and 11. 9%(19/160),respectively. The difference was statistically significant(P ﹤0. 05). There were 17. 5%(11/40)and 17. 5%(11/40)cases with the results of CRUSADE score at high risk and very high risk in the gastrointestinal bleeding group,8. 1%(13/160)and 10. 6%( 17/160 ) cases in the non-gastrointestinal bleeding group,respectively. The difference was statistically significant(P﹤0. 05). Conclusions CRUSADE score can help to evaluate the risk of gastrointestinal bleeding in patients with coronary heart disease who received antiplatelet therapy. It is suggested that the patients with coronary heart disease as well as the CRUSADE score of high risk and very high risk should receive the combination of antiplatelet agents and the proton pump inhibitor,in order to prevent or reduce the gastroin-testinal bleeding.
