二磷酸腺苷介导的血小板聚集抑制率对心律置入装置术后囊袋血肿的影响

Effect of ADP-mediated platelet aggregation inhibition rate on pocket hematoma in patients after arrhythmia control device placement

目的：研究二磷酸腺苷（adenosine diphosphate ，ADP）介导的血小板聚集抑制率对心律置入装置（CIED）置入术后囊袋血肿的影响。方法回顾性分析2010年1月～2013年6月接受持续双重抗血小板药物治疗，需要置入心律置入装置术后发生囊袋血肿的患者43例为血肿组，按照年龄1：1匹配入选术后未发生囊袋血肿的患者43例为无血肿组，分析围术期接受持续双重抗血小板药物治疗患者囊袋血肿的风险因素。结果与无血肿组比较，血肿组ADP介导的血小板聚集抑制率明显升高，差异有统计学意义[（71．33±12．16）％ vs （49．81±14．96）％， P＜0．05]，血小板聚集抑制率ADP＞80％患者比例明显升高，差异有统计学意义[37．21％ vs 13．95％，P＜0.05]。多因素二元logistic分析显示，ADP介导的血小板聚集抑制率＞80％为囊袋血肿风险的独立危险因素（OR＝0.264，95％ CI：0．082～0．850，P＝0．026）。结论增高的ADP介导的血小板聚集抑制率增加持续双重抗血小板药物治疗心律置入装置置入术后囊袋血肿的风险。

Objective To study the effect of adenosine diphosphate （ADP）-mediated platelet aggregation inhibition rate on pocket hematoma in patients after arrhythmia control device placement . Methods Eighty-six patients who underwent arrhythmia control device placement in our hospital from January 2010 to June 2013 after anti-platelet therapy were divided into hematoma group （n=43） and non-hematoma group （n=43） .Risk factors for pocket hematoma during perioperative period were analyzed .Results The ADP-mediated platelet aggregation inhibition rate was signifi-cantly higher in hematoma group than in non-hematoma group （P〈0 .05） .However ,no significant difference was found in arachidonic acid-mediated platelet aggregation inhibition rate between the two groups （P＆gt;0 .05） .Multivariate binary logistic analysis indicated that the ADP-mediated platelet aggregation inhibition rate more than 80% was the risk factor for pocket hematoma（OR=0 .264 ,95% CI：0 .082-0 .850 ,P=0 .026） .Conclusion Elevated ADP-mediated platelet aggregation inhibition rate increases the risk of pocket hematoma in patients after antiarrhythmia control device placement .