目的 探讨冠心病患者实施经皮冠状动脉介入术(PCI)后长期应用氯吡格雷治疗发生出血事件的危险因素.方法 选取2014年1月至2016年3月大连大学附属中山医院循环二科实施PCI治疗的冠心病患者224例,所有患者术后均常规服用氯吡格雷治疗,对患者均进行了6个月的追踪观察,按照患者是否发生出血事件分为出血组47例、非出血组177例,比较两组各项临床资料.结果 冠心病患者PCI术后服用氯吡格雷发生出血事件的独立危险因素为合并高血压、饮酒、消化道溃疡病史、入院诊断为急性冠状动脉综合征(ACS)(OR值分别为1.527、1.908、2.246、1.803,P<0.05).结论 冠心病患者实施PCI后长期应用氯吡格雷治疗发生出血事件的危险因素合并高血压、饮酒、消化道溃疡病史、入院诊断为ACS.%Objective To investigate the risk factors for the occurrence of bleeding in patients with coronary heart disease (CHD) undergoing clopidogrel treatment after percutaneous coronary intervention (PCI). Methods We selected 224 patients with CHD after PCI from January 2014 to March 2016 in our hospital. All the patients received clopidogrel treatment and were followed up for 6 months. According to whether there were bleeding events, the pa-tients were divided into hemorrhage group (47 cases) and non-bleeding group (177 cases). The clinical data were com-pared between the two groups. Results The independent risk factors of bleeding after clopidogrel treatment were hy-pertension, drinking, gastrointestinal ulcer history, and diagnosis of acute coronary syndrome (ACS) at admission (OR=1.527, 1.908, 2.246, 1.803, P<0.05). Conclusion The risk factors of bleeding in patients with CHD with long-term use of clopidogrel after PCI were hypertension, drinking, gastrointestinal ulcer history, and diagnosis of ACS at admission.
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