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目的评价老年冠心病患者择期经皮冠状动脉支架置入术后联合应用氯吡格雷和阿司匹林的有效性和安全性。方法随访因冠心病行支架置入术的老年患者(年龄>65岁)127例,所有患者术后连续服用氯吡格雷75mg/d和阿司匹林100mg/d,共12个月。观察患者服药期间主要心脏不良事件(包括死亡、非致死性急性心肌梗死、心绞痛复发、急性、亚急性或晚期血栓、靶血管重建、脑卒中)以及出血等不良事件的发生率。结果127例患者均无急性、亚急性血栓发生,晚期血栓发生率1.6%(2/127);无死亡;均未发生脑卒中;非致死性急性心肌梗死发生率1.6%(2/127);心绞痛复发发生率3.1%(4/127),靶血管重建发生率2.4%(3/127)。出血的发生率中严重者0.8%(1/127),轻微者3.9%(5/127)。结论老年患者冠状动脉支架置入术后联合应用氯吡格雷及阿司匹林可减少心血管事件的发生且不良反应少,临床实践证明安全有效。
Objective To evaluate the efficacy and safety of combined use of clopidogrel and aspirin in elderly patients with coronary artery disease after percutaneous coronary stent implantation. Methods A total of 127 elderly patients (aged> 65 years) undergoing coronary stent implantation were enrolled. All patients received continuous clopidogrel 75 mg / d and aspirin 100 mg / d for 12 months after operation. The incidence of adverse events such as major adverse cardiac events (including death, non-fatal acute myocardial infarction, recurrence of angina pectoris, acute, subacute or advanced thrombosis, target revascularization, stroke) and bleeding during the course of medication were observed. Results None of the 127 patients had acute or subacute thrombosis, and the incidence of late thrombosis was 1.6% (2/127). No death occurred. No stroke occurred. The incidence of nonfatal AMI was 1.6% (2/127). The incidence of recurrence of angina was 3.1% (4/127) and the incidence of target vessel reconstruction was 2.4% (3/127). The incidence of bleeding was severe in 0.8% (1/127), mild 3.9% (5/127). Conclusion Combined use of clopidogrel and aspirin after coronary stent implantation in elderly patients can reduce the incidence of cardiovascular events with fewer adverse reactions, and clinical practice has proved safe and effective.