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|本期目录/Table of Contents|

老年急性冠脉综合征患者应用替罗非班治疗出血危险因素分析

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2011年第2期
页码:
218-220
栏目:
临床研究
出版日期:
2010-12-10

文章信息/Info

Title:
Risk factors of bleeding complication of tirofiban in elderly patients with acute coronary syndrome
作者:
武强1; 王曙霞2; 郭豫涛2; 张璐2;  蔡军1
解放军总医院：1.国际医学中心,2.老年心内科,北京 100853
Author(s):
WU Qiang1;  WANG Shu-xia2;  GUO Yu-tao2;  ZHANG Lu2;  CAI Jun1
1.International Medical Center, 2.Department of Geriatric Cardiology, PLA General Hospital, Beijing 100853, China
关键词:
替罗非班; 出血; 急性冠脉综合征; 危险因素
Keywords:
tirofiban;  acute coronary syndrome;  safety;  risk factors
分类号:
R541.4;R973.2
DOI:
-
文献标识码:
A
摘要:
目的: 分析老年急性冠脉综合征(ACS)患者应用替罗非班抗血小板治疗出血的危险因素。方法: 67例年龄大于60岁的老年ACS患者接受替罗非班持续静脉滴注36～48 h，观察用药开始至停药3 d内患者出血情况，并对出血可疑危险因素进行单因素和多因素Logistic回归分析。结果: 发生出血6例（9%）,其中重度出血1例，轻度出血5例。多因素Logistic回归分析表明吸烟，OR=3.2, 95%CI 2.2-4.6；年龄每增加10岁，OR=1.4，95%CI 1.1-1.7；血小板聚集率每减少10%，OR=1.6，95%CI 1.2-1.9；肌酐清除率每减少10 ml/min,OR=1.2，95%CI 1.0-1.4；抗凝药及抗血小板药每增加一个，OR=4.2, 95%CI 2.0-5.2。结论： 抗血小板与抗凝药联合应用，吸烟、高龄、血小板聚集率降低、肌酐清除率降低为老年ACS患者应用替罗非班抗血小板治疗出血的主要危险因素。
Abstract:
AIM: To evaluate the risk factors of bleeding complication of tirofiban in elderly patients with acute coronary syndrome (ACS). METHODS: A total of 67 patients (>60 years) with ACS were enrolled from August 2008 to February 2009 and were all given aspirin, clopidogrel, low molecular weight heparin, tirofiban and other anti-ischemic therapy. Tirofiban was given continuously for 36-48 h. Possible risk factors of bleeding complication analyzed included age, sex, smoking, hypertension, diabetes mellitus, blood platelet number, platelet aggregation, body mass index and creatinine clearance rate. RESULTS: Of the six bleeding patients, one patient experienced severe bleeding and five experienced mild bleeding. The results of multivariate stepwise logistic regression analysis indicated that smoking (OR=3.2, 95% CI 2.2-4.6), age (increasing every 10 years, OR=1.4, 95% CI 1.1-1.7), platelet aggregation (decreasing 10% OR=1.6, 95% CI 1.2-1.9), creatinine clearance (decreasing 10 ml/min OR=1.2, 95% CI 1.0-1.4), and anticoagulants and antiplatelet drugs (increasing one drug, OR=4.2, 95% CI 2.0-5.2) were risk factors for bleeding complication of tirofiban in elderly patients with ACS. CONCLUSION: Anticoagulants combined with antiplatelet drugs, smoking, age, platelet aggregation and creatinine clearance are risk factors for bleeding complication of tirofiban in elderly patients with acute coronary syndrome.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2010-03-24.基金项目：中央保健专项资金科研资助项目课题（205） 作者简介：武强，副主任医师Email：china301wuqiang@tom.com
更新日期/Last Update: 2010-12-10