血管入路对中至极高危出血风险急性冠状动脉综合征患者院内出血的影响

目的评估血管入路对Crusade评分为中至极高危出血风险急性冠状动脉综合征患者院内出血(IHMB)的影响。方法对249例经Crusade评分为中至极高危出血风险,行经皮冠状动脉介入(PCI)治疗的非ST段抬高急性冠脉综合征患者资料进行回顾性分析。其中101例患者经桡动脉入路(TRI),148例经股动脉入路(TFI),主要终点为院内主要出血(IHMB)。结果 TRI组IHMB发生率及输血率低于TFI组(P均0.05),2组患者在院内及1 a时的病死率比较均无显著性差异。发生IHMB患者1 a内病死率明显高于未发生IHMB患者(P0.05)。TRI可作为独立的IHMB负性预测因素(P0.01)。结论与TFI相比,TRI可减少有中至极高危出血风险急性冠脉综合征患者的IHMB,IHMB与1 a内病死率明显相关。

Influence of vascular access on in-hospital major bleeding in patients with acute coronary synd rome at moderate to very high bleeding risk

Objective It is to evaluate the influence of vascular access on in -hospital major bleeding （ IHMB） in patients with acute coronary syndrome （ ACS） at moderate to very high bleeding risk diagnosed by Grusade scores .Me thods The data of 249 patients with non-ST elevation ACS treated with PCI at moderate to very high bleeding risk evaluated by Grusade score were retrospectively analyzed, in which a total of 101 patients received trans -radial intervention （ TRI） and 148 patients re-ceived trans-femoral intervention （ TFI） .The primary end-point was IHMB as defined in the Crusade .Results There was no significant differences in one year mortality rate between two groups .However, TRI had lower incidences of IHMB and blood transfusion rate than TFI （P＆lt;0.05）.The patients suffered from IHMB had higher incidences of one year mortality than those free from IHMB （P=0.045）.TRI was an independent negative predictor of IHMB （P=0.003）.Co nclusion IHMB is significantly correlated with one year mortality .Our study suggests that compared to TFI , TRI could reduce IHMB in patients with ACS at moderate to very high bleeding risk .