| 引用本文： |
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李继敏,叶梓,邹誉,等.西洛他唑联合氯吡格雷对冠状动脉药物涂层支架术后支架内再狭窄的影响[J].同济大学学报（医学版）,2017,38(3):56-59, 65. [点击复制]
- LI Ji-min,YE Zi,ZOU Yu,et al.Effect of cilostazol combined with clopidogrel on in-stent restenosis after coronary drug-eluting stenting[J].同济大学学报（医学版）,2017,38(3):56-59, 65. [点击复制]
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| 摘要: |
| 目的 探讨西洛他唑联合氯吡格雷抗血小板治疗对行冠状动脉(冠脉)药物涂层支架术患者支架内再狭窄(in-stent restenosis, ISR)的影响。方法 回顾性分析231例行冠脉药物涂层支架术且术后1年复查冠脉造影的冠心病患者的临床资料。根据不同的抗血小板治疗方案分为两组,其中214例术后1年内服用阿司匹林联合氯吡格雷(阿司匹林组),17例术后服用西洛他唑联合氯吡格雷(西洛他唑组),比较两组术后1年ISR的发生率及再次血运重建率。结果 两组患者的基线资料分析结果显示,西洛他唑组男性患者比例(88.2% vs 76.6%, P<0.001)及有消化道出血病史比例(35.3% vs 0.9%, P<0.001)明显高于阿司匹林组,其他临床资料差异无统计学意义(P>0.05)。支架术后1年,冠脉造影结果显示: 西洛他唑组与阿司匹林组ISR的发生率差异无统计学意义(29.4% vs 12.1%, P=0.06)；西洛他唑组靶血管再次血运重建术与阿司匹林组无统计学差异(5.9% vs 6.1%, P=0.974)；两组其他冠脉病变进展需行冠脉介入治疗(percutaneous coronary intervention, PCI)的患者比例亦无明显差异(17.6% vs 15.4%, P=0.734)。结论 对于行冠脉药物涂层支架术的患者,使用西洛他唑联合氯吡格雷抗血小板治疗与传统双联抗血小板治疗,预防ISR效果相当。对于消化道出血高风险或阿司匹林不耐受的人群,可考虑使用西洛他唑替代阿司匹林进行双联抗血小板治疗。 |
| 关键词: 冠心病 支架 阿司匹林 西洛他唑 氯吡格雷 |
| DOI：10.16118/j.1008-0392.2017.03.011 |
| 投稿时间：2017-10-07 |
| 基金项目: |
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| Effect of cilostazol combined with clopidogrel on in-stent restenosis after coronary drug-eluting stenting |
| LI Ji-min,YE Zi,ZOU Yu,LI Ying |
| (Dept. of Cardiology, East Hospital, Tongji University, Shanghai 200120, China) |
| Abstract: |
| Objective To investigate the occurrence of in-stent restenosis (ISR) of patients using cilostazol combined with clopidogrel as dual antiplatelet therapy (DAPT) following drug-eluting stenting. Methods In this retrospective study, we enrolled 231 patients undergoing percutaneous coronary intervention (PCI) with drug-eluting stent and all patients underwent coronary angiography (CAG) at one year after PCI. Patients were divided into two groups according to differential DAPT. There were 17 patients using cilostazol and clopidogrel as DAPT after PCI (cilostazol group) and 214 patients using conventional aspirin combined with clopidogrel as DAPT (aspirin group). The occurrences of ISR and target vessel revascularization (TVR) were compared at one year after PCI between two groups. Results There were no significant differences in baseline characteristics between two groups, except that more males and more patients with history of gastrointestinal bleeding in cilostazol group than those in aspirin group (88.2% vs 76.6%, P<0.001,5.3% vs 0.9%, P<0.001; respectively). At one year after PCI, the ISR rate of cilostazol group was no significantly different with that in aspirin group (29.4% vs 12.1%, P=0.06). Rates of TVR (5.9% vs 6.1%, P=0.974) and PCI for other lesions (17.6% vs 15.4%, P=0.734) were similar between the two groups. Conclusion Efficacy of cilostazol based DAPT in reducing ISR was similar with conventional DAPT in patients after PCI. Cilostazol as an alternative to aspirin in patients with high risk of gastrointestinal bleeding or aspirin intolerance may be appropriate. |
| Key words: coronary heart disease stent aspirin cilostazol clopidogrel |
