血栓弹力图优化老年慢性稳定性冠心病患者抗血小板治疗的研究

Clinical Efficiency of Using Thromboelastogram for Optimization of Antiplatelet Strategy in Elderly Patients With Stable Coronary Heart Disease

目的采用血栓弹力图(TEG)优化老年稳定性冠心病患者抗血小板治疗方案,旨在为老年冠心病患者抗血小板的个体化治疗提供理论依据。方法共纳入98例老年稳定性冠心病患者,随机分为对照组和观察组(n=49),对照组予以阿司匹林100 mg/d治疗,观察组在对照组基础上,根据TEG检测结果,对血小板聚集抑制率<50%的患者调整抗血小板治疗方案,直至血小板聚集抑制率>50%或已使用双联抗血小板治疗,随访6个月比较两组患者的主要心脏不良事件(MACE)发生情况。结果随访6个月,最终共有96例患者纳入统计。观察组患者MACE发生率较对照组下降(P<0.05),差异有统计学意义。结论 TEG优化老年稳定性冠心病患者抗血小板治疗,降低主要心脏不良事件的发生。

Objectives This study was designed to optimise the antiplatelet regimen using thromboelastogram（TEG）and provide theoretical basis of individual therapy for elderly patients with stable coronary heart disease（SCHD）. Methods A total of 98 elderly patients with SCHD were enrolled in the present study. All the patients were classified into observation group（n=49）and control group（n=49）randomly. Control group was treated with aspirin（100 mg per day）. On the basis of treating control group,observation group of the platelet aggregation inhibition rate less than 50 percent received the therapeutic regimen according to the result tested by TEG until the goals of the platelet aggregation inhibition rate more than 50 percent or dual anti-platelet therapy were reached. The major adverse cardiac events（MACE）of both groups were compared after following up for 6 months.Results After follow-up of 6 months,finally 96 cases were included in the statistics. The incidence of MACE in observation group was lower significantly than that in observation group（P〈 0.05）. Conclusion TEG can plays an important part in optimising the antiplatelet strategy for elderly patients with SCHD,which reduces the incidence of MACE.