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目的探讨经皮冠状动脉介入治疗术(PCI)后患者对二级预防的依从性及其与长期预后的关系。方法 262例PCI术后患者,对其进行随访,调查的药物包括他汀类、钙通道拮抗剂(CCB)、β受体阻滞剂、血管紧张素酶转换酶抑制剂(ACEI)或血管紧张素Ⅱ受体拮抗剂(ARB)、硝酸酯类、阿司匹林和氯吡格雷等,探讨患者接受药物治疗、吸烟状况和主要心脏不良事件(MACE)发生情况之间的关系。结果术后患者他汀类、CCB、β受体阻滞剂、ACEI/ARB、硝酸酯类、阿司匹林和氯吡格雷的应用率分别为82.8%、20.2%、65.3%、40.1%、46.2%、97.7%,随访时分别为66.0%、17.6%、55.7%、35.9%、35.1%、92.7%,14例(5.3%)患者术后停用双重抗血小板治疗药物,8例(3.1%)患者术后停用所有药物。手术前吸烟者142例(54.2%),术后大多数患者彻底戒烟,但随访时有47例(17.9%)患者没有彻底戒烟。停药患者和术后吸烟患者MACE和非致死性心肌梗死发生率显著高于未停药患者和戒烟患者(P<0.05)。结论接受PCI治疗的冠心病患者术后对于二级预防具有良好的依从性,术后停抗血小板治疗药物和吸烟患者的预后较差。
Objective To investigate the compliance of secondary prevention and its relationship with long-term prognosis after percutaneous coronary intervention (PCI). Methods A total of 262 patients undergoing PCI were followed up. The investigators included statins, calcium channel blockers (CCBs), beta blockers, angiotensin converting enzyme inhibitors (ACEIs) or angiotensin Ⅱ receptor antagonists (ARBs), nitrates, aspirin, and clopidogrel to explore the relationship between patients receiving medication, smoking status and major adverse cardiac events (MACE). Results The postoperative application rates of statins, CCB, β blockers, ACEI / ARB, nitrates, aspirin and clopidogrel were 82.8%, 20.2%, 65.3%, 40.1%, 46.2% and 97.7 %. Patients were treated with dual antiplatelet drugs after 66.0%, 17.6%, 55.7%, 35.9%, 35.1%, 92.7%, and 14 cases (5.3% Disable all medications. Preoperative smokers in 142 cases (54.2%), most patients after smoking cessation, but at follow-up, 47 patients (17.9%) did not quit smoking completely. The incidence of MACE and non-fatal myocardial infarction were significantly higher in patients with drug withdrawal and postoperative smoking than those without drug withdrawal and smoking cessation (P <0.05). Conclusions Patients with coronary artery disease treated with PCI have good compliance with secondary prevention after operation, and patients with antiplatelet drugs and smoking have a poor prognosis after operation.