肠溶阿司匹林和氯吡格雷在抗血小板治疗中上消化道出血的相关危险因素分析

目的]分析肠溶阿司匹林和氯吡格雷在抗血小板治疗中导致上消化道出血的相关危险因素.方法]回顾性分析2009年2月至2013年5月冠状动脉硬化性心脏病患者98例的临床资料,其中58例患者采用肠溶阿司匹林联合氯吡格雷抗血小板治疗（观察组）;其余40例患者则单独采用肠溶阿司匹林或氯吡格雷抗血小板治疗（对照组）,比较两组患者的上消化道出血发生率并分析统计导致患者上消化道出血的相关危险因素.结果]观察组上消化道出血发生率8.6％明显高于对照组2.5％（P＜0.05）;Logistic回归分析发现高龄（＞60岁）、服用时间超过3个月、有既往消化道出血病史和抗血小板药物联合使用是抗血小板治疗中增加上消化道出血的危险因素.结论]抗血小板药物联合使用增加患者上消化道出血的几率,同时对高龄、服药时间较久及既往有上消化道出血史的患者应高度警惕上消化道出血的可能.

Relevant Risk Factors of Upper Gastrointestinal Bleeding after Antiplatelet Therapy with Enteric-coated Aspirin and Clopidogrel

Objective]To analyze the related risk factors of upper gastrointestinal bleeding after antiplatelet therapy with enteric-coated aspirin and clopidogrel.Methods] Clinical data of 98 patients with coronary arteriosclerotic heart disease from Feb.2009 to May 2013 were analyzed retrospectively.Among them,58 patients（observation group） received antiplatelet therapy with enteric-coated aspirin and clopidogrel,and 40 patients（control group） received antiplatelet therapy with enteric-coated aspirin or clopidogrel alone.The incidence of upper gastrointestinal bleeding was compared between two groups.The related risk factors of upper gastrointestinal bleeding were analyzed statistically.Results] The incidence of upper gastrointestinal bleeding in observation group was obviously higher than that in control group（8.6 ％ vs.2.5 ％） （P ＜0.05）.Logistic regression analysis showed that the advanced age（＞ 60 years）,drug administration for more than 3 months,the history of previous gastrointestinal bleeding and combination use of antiplatelet drugs were risk factors of the increasing of upper gastrointestinal bleeding.Conclusion]The combined use of antiplatelet drugs may increase the probability of upper gastrointestinal bleeding in patients.For the patients with the advanced age,drug administration for a long time and the history of previous upper gastrointestinal bleeding,the probabilityof upper gastrointestinal bleeding should be highly cautioned.