目的观察经皮冠脉内介入术(percutaneous coronary intervention,PCI)后使用西洛他唑对阿司匹林致上消化道出血患者的外周血血小板聚集率、PGE2及心血管事件发生率的影响。方法 64例确诊冠心病并行PCI术后的患者,服用阿司匹林和氯吡格雷双重抗血小板治疗出现阿司匹林相关上消化道出血,其中32例患者改用西洛他唑加氯吡格雷,而另外32例患者出血治疗后继续原抗血小板治疗方案,随访比较两组患者血小板聚集率、PGE2及心血管事件发生率。结果平均随访(0.9±0.1)年,两组患者血小板聚集率均明显下降,西洛他唑组的血小板聚集率显著低于阿司匹林组(P<0.05),外周血PGE2的浓度高于阿司匹林组(P<0.05),但两组患者临床不良事件发生率差异无统计意义。结论对PCI术后上消化道出血患者,应用西洛他唑替代阿司匹林,联用氯吡格雷进行抗血小板治疗,经过短期的临床观察,其血小板聚集率优于阿司匹林,升高外周血PGE2的浓度,且安全性与阿司匹林相当,可用于预防上消化道出血的复发。 Objective To observe the effects of cilostazol on peripheral blood platelet aggregation, PGE2 and cardiovascular events in patients with aspirin-induced upper gastrointestinal hemorrhage after percutaneous coronary intervention (PCI). Methods Sixty-four patients diagnosed with coronary heart disease complicated with PCI were enrolled in the study. Aspirin-related upper gastrointestinal bleeding was induced by aspirin and clopidogrel dual antiplatelet therapy. 32 patients were switched to cilostazol plus clopidogrel while the other 32 patients After the treatment of bleeding, the patient continued the original anti-platelet therapy. The platelet aggregation rate, PGE2 and the incidence of cardiovascular events were compared between the two groups. Results After a mean follow-up of (0.9 ± 0.1) years, the platelet aggregation rate was significantly decreased in both groups, and the platelet aggregation rate in cilostazol group was significantly lower than that in aspirin group (P <0.05). The PGE2 concentration in peripheral blood was higher than that in aspirin group P <0.05), but there was no significant difference in the incidence of clinical adverse events between the two groups. Conclusion For patients with upper gastrointestinal bleeding after PCI, the application of cilostazol instead of aspirin, combined with clopidogrel antiplatelet therapy, after a short period of clinical observation, the platelet aggregation rate is superior to aspirin, elevated peripheral blood PGE2 concentration , And safety and aspirin equivalent, can be used to prevent the recurrence of upper gastrointestinal bleeding.