查詢結果分析
來源資料
相關文獻
- 抗血小板藥物的使用對消化道內視鏡相關治療影響之探討
- 臺灣地區高風險藥物與中藥併用之藥物流行病學研究
- Aspirin與Clopidogrel併用下發生之硬腦膜下出血--病例報告暨文獻回顧
- 當發生上胃腸道出血時,心血管疾病患者由Aspirin改為Clopidogrel的迷思
- 探討腦中風復發病人使用單抗血小板藥物與雙抗血小板藥物在3個月內復發率與出血風險之安全性
- 成人上消化道出血之鑑別與處置
- 抗血小板藥物相關腦出血的處置
- Metastatic Hepatocellular Carcinoma Presenting as Hemocholecyst with Perforation: A Case Report
- One-Week Low-Dose Triple Therapy is Effective in Treating Helicobacter Pylori-Infected Patients with Bleeding Peptic Ulcers
- Hypothalamic Juvenile Pilocytic Astrocytoma Presenting with Intracerebral Hemorrhage
頁籤選單縮合
題 名 | 當發生上胃腸道出血時,心血管疾病患者由Aspirin改為Clopidogrel的迷思=The Myth Associated with Changing Aspirin to Clopidogrel in Carduovassulor Disease when upper gastrointestinal Bleeding Occurs |
---|---|
作 者 | 高慧如; 莊瑞蓉; | 書刊名 | 澄清醫護管理雜誌 |
卷 期 | 4:1 2008.01[民97.01] |
頁 次 | 頁34-39 |
分類號 | 415.38 |
關鍵詞 | 抗血小板藥物; 出血; Aspirin; Clopidogrel; Ticlopidine; Antiplatelet; Bleeding; |
語 文 | 中文(Chinese) |
中文摘要 | 本篇主要回顧近年來有關心血管疾病忠者先 前已有使用阿斯匹靈(aspirin)造成上胃腸道出血病 史或者是先前已有上胃腸道出血者使用抗血小板藥 物clopidogrel後發生胃腸道出血風險的研究,最近 的研究發現在上述狀況下單獨使用clopidogrel並沒 有減少上胃腸道再度出血的風險,但不論是aspirin 或是clopidogrel併用質子幫浦抑制劑(protonpump inhibitor, PPI)都可以有效的降低再度上消化道出血 的風險。大於70歲的老人,有上胃腸道出血病史, 併用其他抗血小板藥物、抗凝血劑、非類固醇消炎 藥都是使用抗血小板藥物息者發生上胃腸道出血的 重要危險因子。我們也同時回顧與clopidogrel同屬 thienopyridine類衍生物的tic10pidine '其每日劑量不 超過250毫克時較低劑量aspirin有較少的上胃腸道 出血風臉,但是由於其他如白血球低下、血小板低 下、肝功能異常等的副作用,tic10pidine的使用仍 舊有較多的限制。隨著越來越多的證據,我們建 議當忠者之前已有上胃腸道出血的病史時,或者是 因aspirin所導致的上胃腸道出血,抗血小板藥物加 上PPI是長期有服用抗血小板藥物需要的患者目前 的最佳選擇。 |
英文摘要 | This paper focus on re-bleeding risk when clopidogrel is used in carduovassulor disease after the occurrence of aspirin related upper gastrointestinal bleeding or when there is a previous history of upper gastrointestinal bleeding. Recent evidence has shown that clopidogrel alone, when used for the above conditions, does not reduce the risk of recurrent upper gastrointestinal bleeding. Furthermore aspirin with a proton pump inhibitor (PP/) or clopidogrel with a PPI are each able to reduce the effective recurrence rates of upper gastrointestinal bleeding. (Patients who are older than 70 years old, who have a history of upper gastointenstinal bleeding or who are concomitantly using other antiplatelet, anticoagulant or nonsteroidal anti- inflammatoηy drugs are major gastrointestinal bleeding risk fiαtors of antiplatelet drug users.) We also review ticlopidine, which belongs to fhie nopyridine derivative group of drugs like clopidogrel. Ticlopidine at doses under 250mg/ day shows a lower risk of upper gastrointestinal bleeding than low dose aspirin. The use of this drug is limited by side Effects such as neutropenia thrombocytopenia abnormal liver function, etc. After assessment using evidence-base medicine, we suggest that an antiplatelet drug plus a PPI is the best solution for patients who need long-term antiplatelet therapy and who have a past histoη1 of upper gastrointestinal bleeding or aspirin related gastrointestinal bleeding. |
本系統中英文摘要資訊取自各篇刊載內容。