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8例急性冠脉综合征合并上消化道出血的治疗体会 被引量:2

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摘要 目的:探讨急性冠脉综合征(ACS)合并上消化道出血患者在不能进行抗凝(溶栓)时的治疗方法及效果。方法:入选8例ACS合并出血患者,均予抑酸剂,他汀类强化调脂及硝酸酯类治疗,符合一定条件者给予β受体阻滞剂及输血治疗。于止血后,在胃粘膜保护情况下,加小剂量肠溶阿斯匹林,观察有无再发出血。结果:心绞痛患者症状明显缓解,总有效率85.71%,1例心梗患者死亡。余无心脏恶性事件发生。院外随访,无再发上消化道出血。结论:强化调脂、β受体阻滞剂及适当输血治疗对于急性冠脉综合征合并上消化道出血患者有重要意义。对有出血史冠心病患者,在胃粘膜保护下,可考虑应用小剂量肠溶阿斯匹林。
出处 《心血管康复医学杂志》 CAS 2007年第2期182-184,共3页 Chinese Journal of Cardiovascular Rehabilitation Medicine
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  • 1Schartl M, Bocksch W, Koschyk DH, et al. Use of intravascular ultrasound to compare effects of different strategies of lipidlowering therapy on plaque volume and composition in patients with coronary artery disease[J]. Circulation, 2001, 104(4): 387 - 392.
  • 2Crisby M, Nordin-Fredriksson G, Shah PK, et al. Pravastatin treatment increases collagen content and decreases lipid content, inflammation, metalloproteinases, and cell death in human carotid plaques : implications for plaque stabilization [ J ]. Circulation,2001,103(7) : 926 - 933.
  • 3Takano M, Mizuno K, Yokoyama S, et al. Changes in coronary plaque color and morphology by lipid-lowering therapy with atorvastatin: serial evaluation by coronary angioscopy[J]. J Am Coil Cardiol, 2003, 42(4): 680- 686.
  • 4Stenestrand U, Wallentin L. Early statin treatment following acute myocardial infarction and 1-year survival [ J]. JAMA, 2001,285:430 - 436.
  • 5Spencer FA, Allegrone J, Goldberg RJ, et al. Association of statin therapy with outcomes of acute coronary syndrome: the GRACE study[J]. Ann Intern Med, 2004,140:857- 866.
  • 6Schwartz GG, Olsson AG, Ezekowitz MD, et al. Effects of atorvastain on early recurrent ischemic events in acute ccoronary syndromes- the MIRACLE study. Arandomized controlled trial[J]. JAMA, 2001,285:1711- 1718.
  • 7Cannon CP, I Braunwald E, McCabe C, et al. Intensive versus moderate lipid lowering with statins after acute coronary syndromes[J]. N Engl J Med, 2004,350:1495- 1504.
  • 8Naghavi M, Libby P, Falk E, et al. From vulnerable plaque to vulnerable patient: a call for new definitions and risk assessment strategies: Part Ⅰ[J]. Circulation, 2003, 108(14): 1664 - 1672.
  • 9Topoi EJ. Intensive statin therapy-A sea change in cardiovascular prevention[J]. N Engl J Med, 2004,350:1562- 1564.
  • 10LaRosa JC, Grundy SM, Waters DD, et al. Intensive lipid lowering with atorvastatin in patients with stable coronary disease[ J]. N Engl J Med, 2005,352 : 1425 - 1435.

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  • 1Moscucci M, Fox KA, Cannon CP, et al. Predictors of major bleed- ing in acute coronary syndromes: the Global Registry of Acute Cor- onary Events (GRACE) [J]. Eur Heart J, 2003, 24(20): 1815-1823.
  • 2AI-Mallah M, Bazari RN. Predictors and outcomes associated with gastrointestinal bleeding in patients with acute coronary syndromes [J]. J Thromb Thrombolysis, 2007, 23(1): 51-55.
  • 3Al-Mallah M,Bazari RN,Jankowski M. Predictors and outcomes associated with gastrointestinal bleeding in patients with acute coronary syndromes[J].Journal of Thrombosis and Thrombolysis,2007,(01):51-55.
  • 4Bhatt DL,Cryer BL,Contant CF. Clopidogrel with or without omeprazole in coronary artery disease[J].New England Journal of Medicine,2010,(20):1909-1917.
  • 5Harjai KJ,Shenoy C,Orshaw P. Clinical outcomes in pa tients with the concomitant use of clopidogrel and proton pump inhibitors after percutaneous coronary intervention:an analysis from the Guthrie Health Off-Label Stent (GHOST) investigators[J].Circ Cardiovasc Interv,2011,(02):162-170.
  • 6Liu TJ,Jackevicius CA. Drug interaction between clopidogrel and proton pump inhibitors[J].Pharmacotherapy:The Journal of Human Pharmacology & Drug Therapy,2010,(03):275-289.
  • 7Moscucci M,Fox KA,Cannon CP. Predictors of major bleeding in acute coronary syndromes:the Global Registry of Acute Coronary Events (GRACE)[J].European Heart Journal,2003,(20):1815-1823.
  • 8Manoukian SV,Feit F,Mehran R. Impact of major bleeding on 30-day mortality and clinical outcomes in patients with acute coronary syndromes:an analysis from the ACUITY Trial[J].Journal of the American College of Cardiology,2007,(12):1362-1368.
  • 9Sapoznikov B,Vilkin A,Hershkovici M. Minidose aspirin and gastrointestinal bleeding a retrospective,case-control study in hospitalized patients[J].Digestive Diseases and Sciences,2005,(09):1621-1624.doi:10.1007/s10620-005-2906-0.
  • 10Bhatt DL,Scheiman J,Abraham NS. ACCF/ACG/AHA 2008 expert consensus document on reducing the gastrointestinal risks of antiplatelet therapy and NSAID use:a report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus documents[J].Circulation,2008,(18):1894-1909.doi:10.1161/CIRCULATIONAHA.108.191087.

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