血栓弹力图评测老年患者口服抗血小板药物疗效的临床研究

Clinical research on evaluation of results of oral antiplatelet drugs in old Patients by Thrombelastogram

目的:探讨运用血栓弹力图检测老年患者服用抗血小板药物后血小板抑制率的变化。方法:通过本院就诊60例老年患者,运用血栓弹力图测得AA和ADP途径诱导的血小板抑制率,将患者分成阿司匹林组(Ⅰ组)、氯吡格雷组(Ⅱ)、阿司匹林+氯吡格雷组(Ⅲ组),与正常对照组(Ⅳ组)30例进行统计分析。结果:60例患者中,阿司匹林组AA诱导的血小板抑制率为87.1±20.8%,氯吡格雷组ADP诱导的血小板抑制率为48.6±24.3%,阿司匹林+氯吡格雷组AA诱导和ADP诱导的血小板抑制率为分别92.2±13.1%和53.9±23.2%,血小板抑制率均显著高于对照组(P<0.01)。结论:通过血栓弹力图能客观地反映老年患者服用抗血小板药物后血小板抑制率的变化,阿司匹林抗血小板作用优于氯吡格雷,同时服用阿司匹林和氯吡格雷能起到更强的抗血小板作用。

Objective： To probe into the use of thromboelastograms （TEG） to evaluate the change of platelet inhibition rate after taking antiplatelet drugs in old patients. Methods： Detect the platelet inhibition rate induced by AA and ADP ways through the 60 old patients in our hospital, and put the patients into aspirin group （group I ）,clopidogrel group （group ]I ）, aspirin＋clopidogrel group（group Ⅲ）, then make a statistical analysis in the 30 patients of conventional control group（group IV）. Results： In the 60 patients, platelet inhibition rate induced by AA in aspirin group is 87.1 - 20.8%. platelet inhibition rate induced by ADP in clopidogrel group is 48.6＋ 24.3%, platelet inhibition rate induced by AA and ADP are respectively 92.2 ＋ 13.1% and 53.9 - 23.2% in aspirin＋clopidogrel group, platelet inhibition rates of this group are both significantly higher than the control group （P〈0.01）. Conclusion： The thromboelastograms （TEG） can reflect the change of platelet inhibition rate objectively after taking antiplatelet drugs in the old patients. The antiplatelet effects of aspirin is better than clopidogrel, the antiplatelet effects will be stronger if the patients take aspirin and clopidogrel at the same time.