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目的了解经皮冠状动脉介入治疗(PCI)术后抗血小板药物的应用是否规范,并对其可能的原因进行分析。方法对2001-07-01—2002-06-30与2003-07-01—2004-06-30两个时间段内,于首都医科大学附属北京安贞医院心内科行PCI治疗的注册研究患者进行回顾分析,研究其术后抗血小板治疗药物的种类、联合用药、药物剂量及服用时间。结果1728例患者接受了PCI治疗,其中1006例患者置入药物洗脱支架(DES组),518例置入普通金属支架(BMS组),192例患者同时置入了DES与BMS,12例患者单纯球囊扩张。术后有70例患者未继续使用任何抗血小板治疗药物。其余1658例患者使用1种或1种以上抗血小板治疗药物。进一步分析BMS组与DES组术后抗血小板药物的使用情况,术后未使用任何抗血小板药物(BMS组52例,DES组18例,P<0.001),只使用阿司匹林一种抗血小板药物(BMS组236例,DES组180例,P<0.001),只使用噻吩并吡啶类药物(BMS组45例,DSE组39例,P>0.05),使用阿司匹林加噻吩并吡啶类药物双重抗血小板治疗(BMS组350例,DES组808例,P<0.001)。结论冠状动脉介入治疗术后的抗血小板治疗有待进一步加强,提高抗血小板药物的依从性,降低PCI术后并发症的发生。
Objective To understand whether the application of antiplatelet drugs after percutaneous coronary intervention (PCI) is standardized and analyze its possible causes. METHODS: The patients undergoing PCI from the Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University during 2001-07-01-2002-06-30 and 2003-07-01-2004-06-30 were enrolled. Retrospective analysis to study the type of antiplatelet drugs, combination therapy, drug dose and taking time. Results A total of 1728 patients underwent PCI. One hundred and sixty-six patients underwent DES (DES group), 518 patients underwent general metal stent (BMS group), 192 patients underwent both DES and BMS, and 12 patients Simple balloon dilatation. After surgery, 70 patients did not continue to use any antiplatelet drugs. The remaining 1658 patients used one or more antiplatelet agents. Further analysis of postoperative antiplatelet use in the BMS and DES groups did not use any antiplatelet agents (52 in the BMS group and 18 in the DES group, P <0.001), and only aspirin, an antiplatelet agent (BMS (236 in the control group, 236 in the DES group and 180 in the DES group, P <0.001). Only thienopyridines (45 in the BMS group and 39 in the DSE group, P> 0.05) were treated with aspirin plus thienopyridine dual antiplatelet therapy 350 in the BMS group and 808 in the DES group, P <0.001). Conclusion The antiplatelet therapy after coronary intervention needs to be further strengthened to improve the compliance of antiplatelet drugs and reduce the incidence of complications after PCI.