Pfisterer M, Jockers G, Burkart F, Schmitt H E, Wolff G, Skarvan K, Stulz P, Hasse J, Grädel E
Department für Innere Medizin, Universitätsspital Basel.
Schweiz Med Wochenschr. 1987 Oct 24;117(43):1688-92.
The effects of antiplatelet therapy (AP; dipyridamole 400 mg [beginning 2 days preoperatively] + aspirin 50 mg/day) and anticoagulation (AC) were compared prospectively in 251 patients with coronary artery bypass grafting (CABG). Two weeks postoperatively, 85.2% of AP and 81% of AC patients had all grafts patent with graft patency rates of 93.6% and 91.3% respectively (p = n.s.) Significant differences in favour of AP therapy were found in subgroups with multiple grafts and with low intraoperative graft flow. Up to 3 months postoperatively, severe complications occurred in 22 AC patients (11 bleedings) but only in 9 patients on AP therapy (p less than 0.01). Overall, AP therapy should therefore be preferred to AC in patients with CABG surgery.
对251例行冠状动脉旁路移植术（CABG）的患者进行了前瞻性比较，观察抗血小板治疗（AP；双嘧达莫400mg[术前2天开始]+阿司匹林50mg/天）和抗凝治疗（AC）的效果。术后两周，85.2%接受AP治疗的患者和81%接受AC治疗的患者所有移植血管通畅，移植血管通畅率分别为93.6%和91.3%（p=无统计学意义）。在多支血管移植和术中移植血管血流较低的亚组中，发现AP治疗有显著优势。术后3个月内，22例接受AC治疗的患者出现严重并发症（11例出血），而接受AP治疗的患者仅有9例出现严重并发症（p<0.01）。因此，总体而言，CABG手术患者中，AP治疗应优于AC治疗。
