急性冠状动脉综合征患者治疗后出血相关因素分析.docVIP

急性冠状动脉综合征患者治疗后出血相关因素分析 　　[摘 要] 目的：探讨急性冠状动脉综合征（Acute coronary syndrome，ACS）患者治疗后出血的相关因素，为预防出血提供参考。方法：对我科收治的955例ACS患者进行回顾性分析，按照其治疗后出血发生情况分为出血组、未出血组，统计出血发生率，比较两组患者临床资料并归纳影响ACS患者治疗后合并出血的相关因素，探讨防治策略。结果：955例患者中，共有48例患者发生治疗后出血，发生率为5.03%。Logistic多因素回归分析示，年龄≥65岁、非ST段抬高型心肌梗死、既往出血事件、既往CABG手术史、合并肾衰、合并心衰、合并血小板减少、接受氯吡格雷治疗、接受糖蛋白Ⅱb/Ⅲa受体拮抗剂治疗是影响ACS患者治疗后合并出血的独立危险因素。结论：ACS患者治疗后合并出血发生风险较高，年龄、既往史、合并症、治疗方案均可影响出血事件发生率，应早期评估患者出血风险，制定个体化治疗方案。 　　[关键词] 急性冠状动脉综合征；出血；影响因素 　　中图分类号：R541.4 文献标识码：B 文章编号：2095-5200（2016）06-021-03 　　DOI：10.11876/mimt201606008 　　Analysis on correlation factors of hemorrhage after treatment in patients with acute coronary syndrome NIU Guangmei，ZHENG Rongmei. （Department of cardiologyThe，Third People，s Hospital of Guangyuan，Guangyuan 628400 China） 　　[Abstract] Objective： This study aimed to investigate the related factors of hemorrhage in patients with acute coronary syndrome （ACS） after treatment， and to provide reference for the prevention of bleeding. Methods： 955 cases of patients with ACS were retrospectively analyzed， and divided into bleeding group and non-bleeding group according to the occurrence of bleeding after treatment， bleeding incidence was stastically analyzed， clinical data were compared between the two groups， the related factors influencing the hemorrhage of ACS patients after treatment， and the prevention and treatment strategies were discussed. Results： Among 955 patients， there were 48 patients with hemorrhage after treatment， the incidence rate was 5.03%. Logistic regression analysis showed that age more than 65 years old， non-ST-elevation myocardial infarction， previous bleeding， previous coronary artery bypass grafting surgery （CABG） surgery， complicated with renal failure， heart failure and thrombocytopenia， accepting clopidogrel therapy and glycoprotein II b/ III a receptor antagonist therapy were independent risk factors of the hemorrhage after treatment of ACS patients. Conclusions： There is high risk bleeding incidence in ACS patient