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	运用CRUSADE评分系统评估非ST段抬高性急性冠脉综合征患者双重抗血小板治疗后的出血风险
	牛永红 ; 康林 ; 李馨 ; 张涛 ; 王丽宁 ; 李群 ; NIU Yong-hong ; KANG Lin ; LI Xin ; ZHANG Tao ; WANG LI-ning ; LI Qun
	2016-03-30 ; 2016-03-30
关键词	冠状动脉疾病 CRUSADE评分系统 抗血小板 出血 coronary artery disease CRUSADE scoring system percutaneous coronary intervention R541.4
其他题名	Application of CRUSADE scoring system in assessment of hemorrhage in patients with non-STelevation acute coronary syndromes after percutaneous coronary intervention
中文摘要	目的运用CRUSADE评分系统对非ST段抬高性急性冠脉综合征(non-ST-elevation acute coronary syndromes,NSTE-ACS)患者抗栓治疗后的出血风险进行评估。方法选择2009年1月至2011年6月在清华大学第一附属医院住院的NSTE-ACS患者共245例,对每例患者行CRUSADE评分并进行危险分层,其中包括不稳定型心绞痛(unstable angina,UA)患者115例[男68例,女47例,年龄为(63.5±3.6)岁],非ST段抬高性心肌梗死(non-ST-elevation myocardial infarction,NSTEMI)患者130例[男79例,女51例,年龄为(66.2±9.1)岁]。所有患者均服用双重抗血小板药物(阿司匹林与氯吡格雷联用)1年,观察期间的出血发生率。结果 245例NSTE-ACS患者中共有23例发生主要出血事件,出血发生率为9%,其中消化道出血的发生率最高,占整个出血人群的50%以上,其次为泌尿系统出血,脑出血和肺出血发生率相对较低。在115例UA患者中1年内共有7例发生了主要出血事件,总的出血发生率为6%,由极低危组到极高危组出血发生率依次为0%、0%、0.9%、1.7%、3.5%;130例NSTEMI患者中1年内有16例发生了主要出血事件,总的出血发生率为12%,由极低危组到极高危组出血发生率依次为0.8%、0.8%、1.5%、3.1%、6.0%。高危组和极高危组的出血风险显著高于其余各组,差异有统计学意义(P<0.05)。结论随着危险分层级别(CRUSADE评分)增大,出血发生率呈增加趋势,CRUSADE评分系统对于NSTE-ACS患者出院后长期双联抗血小板治疗的出血风险有良好的评估价值。; Objectives To evaluate the application of CRUSADE scoring system in prediction of hemorrhage in patients with non-ST-elevation acute coronary syndromes(NSTE-ACS) after percutaneous coronary intervention(PCI). Methods CRUSADE scoring system was conducted in randomly collected 245 patients with NSTE-ACS who had PCI therapy in The First Affiliated Hospital of Tsing Hua University from January 2009 to June 2011. The patients were divided into unstable angina(UA) group [n=115, 68 males and 47 females,(63.5�.6) years] and non-ST-elevation myocardial infarction(NSTEMI) group [n=130, 79 males and 51 females,(66.2�.1) years]. All patients took aspirin and clopidogrel for 1 year. Incidence of hemorrhage was observed during the period. Results There were 23 patients with obvious hemorrhage in the 245 NSTE-ACS patients, and the bleeding rate was 9%. The highest hemorrhage incidence was gastrointestinal events(>50%), followed by urinary tract hemorrhage. Cerebral hemorrhage and pulmonary hemorrhage incidence rates were relatively low. There were 7 patients with obvious hemorrhage in the 115 UA patients during the observation period, and the incidence of hemorrhage was 6%. Hemorrhage incidence rates from extremely-low-risk group to extremely-high-risk group were 0%, 0%, 0.9%, 1.7%, 3.5%. There were 16 patients with obvious hemorrhage in the 130 NSTEMI patients during the observation period, and the incidence of hemorrhage was 12%. Hemorrhage incidence rates from extremely-low-risk group to extremely-high-risk group were 0.8%, 0.8%, 1.5%, 3.1%, 6.0%. Hemorrhageincidence rates in extremely-high-risk and high-risk groups were significantly higher than those in other groups(P<0.05).Conclusions The incidence rate of hemorrhage escalates with the increase of CRUSADE score. CRUSADE scoring system is valuable in the assessment of the hemorrhage incidence in patients with NSTE-ACS after PCI.
语种	中文 ; 中文
内容类型	期刊论文
源URL	[http://ir.lib.tsinghua.edu.cn/ir/item.do?handle=123456789/147277]
专题	清华大学
推荐引用方式 GB/T 7714	牛永红,康林,李馨,等. 运用CRUSADE评分系统评估非ST段抬高性急性冠脉综合征患者双重抗血小板治疗后的出血风险[J],2016, 2016.
APA	牛永红.,康林.,李馨.,张涛.,王丽宁.,...&LI Qun.(2016).运用CRUSADE评分系统评估非ST段抬高性急性冠脉综合征患者双重抗血小板治疗后的出血风险..
MLA	牛永红,et al."运用CRUSADE评分系统评估非ST段抬高性急性冠脉综合征患者双重抗血小板治疗后的出血风险".(2016).

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