摘要
目的：调查分析小剂量阿司匹林（LDA）对心脑血管病一级预防、二级预防的疗效以及出血等不良反应.方法：自行设计问卷调查表,采取面对面回答的方式填写调查表,并查阅患者的就诊病历、检验报告等,核实患者提供的基本信息（包括疾病诊断、用药情况）,回顾调查分析2010年1月到2012年12月我院门诊和住院及社区使用小剂量阿司匹林预防心脑血管病的患者1000例.结果：与LDA相关的不良反应发生者共计236例（23.6%）;其中消化道不良反应127例（12.7%）[包括消化道出血75例（7.5%）],脑出血12例（1.2%）,鼻腔出血15例（1.5%）,牙龈出血10例（1.0%）,皮肤黏膜出血18例（1.8%）,血尿9例（0.9%）,眼睛球结膜出血45例（4.5%）.老年人460例中不良反应发生者共计147例（31.96%）,其中严重的脑出血10例（2.17%）,严重的消化道出血59例（12.83%）;540例中非老年人不良反应发生者共计89例（16.48%）,其中严重的脑出血2例（0.37%）,严重的消化道出血16例（2.96%）.总不良反应发生率老年人与非老年人两者比较,差异有统计学意义（χ2=3.98,P〈0.05）;严重的出血发生率老年人与非老年人两者比较,差异有统计学意义（χ2=42.38,P〈 0.001）.结论：小剂量阿司匹林（50～325 mg/d）依然存在安全性问题;其出血及消化道等不良反应值得临床密切关注.应用小剂量阿司匹林预防心脑血管病应注意预防出血等不良反应的发生.对老年人服用小剂量阿司匹林要给予特别关注和严密监测.
Objective： To investigate the low-dose aspirin for primary prevention and secondary prevention of cardiovascular and cerebrovascular disease, the efficacy and bleeding or other adverse reactions. Methods： To design the questionnaire, face-to-face answer to fill in the questionnaire and consult with patient medical records, inspection reports to verify patients to provide the basic information （ including disease diagnosis, drug use） , retrospective survey in January 2010 to December 2012 our clinic and hospi- tal and community use of low-dose aspirin to prevent cardiovascular and cercbrovascular disease in patients with 1000 cases. Re- sults： The LDA-associated adverse events of a total of 236 cases （23.6%）; 127 cases of gastrointestinal adverse reactions （ 12.7% ） , including 75 cases of gastrointestinal bleeding （7.5%） ] , cerebral hemorrhage in 12 cases （ 1.2% ） , nasal bleeding in 15 cases （ 1.5% ） , bleeding gums in 10 cases （ 1.0% ） , skin and mucous membrane bleeding in 18 cases （ 1.8% ） , hematu- ria 9 cases （0.9%） , the eye ball conjunctival hemorrhage in 45 cases （4.5%）. A total of 147 cases the elderly 460 cases of ad- verse reactions occur （31.96%） , severe brain hemorrhage in 10 cases （2. 17% ） , severe gastrointestinal bleeding in 59 cases （ 12.83% ）. Non-elderly 540 cases of adverse reactions occur by a total of 89 cases （ 16.48% ） , including severe brain hemor-rhage in 2 cases （0.37%） , severe gastrointestinal bleeding in 16 patients （2.96%）. Total adverse reaction incidence of both the elderly and non-elderly, the difference EC-meter significant （X2 -- 3.98, P 〈 O. 05 ） ; serious bleeding rates compared both of the elderly and non-elderly, the difference EC-considered significant （X2 = 42.38 P 〈 0. 001 ）. Conclusion： low-dose aspirin （50 to 325 mg / d） security issues still exist, and bleeding and gastrointestinal adverse reactions worthy of close attention. Low-dose aspi- rin to prevent cardiovascular and cerebrovascular disease should pay attention to prevent the occurrence of bleeding and other adverse reactions. Taking low-dose aspirin should be given special attention and close monitoring of the elderly.
出处
《中国药物评价》
2013年第5期288-290,294,共4页
Chinese Journal of Drug Evaluation
基金
山西省科技攻关计划项目(编号:20100311111)
关键词
小剂量阿司匹林
心脑血管病
一级预防
二级预防
不良反应
出血
Low-dose aspirin
Cardiovascular and cerebrovascular disease
Primary prevention
Secondary prevention
Adverse re- actions
Bleeding
