摘要
目的：采用血栓弹力图（thrombelastography，TEG）评价经皮冠脉介入治疗（percutaneous coronary intervention，PCI）患者服用抗血小板药物后血小板的抑制效果，以指导临床对患者抗血小板聚集药物治疗的个性化调整。方法选择101例冠心病 PCI 术后的住院患者，其中77例联用阿司匹林与氯吡格雷作为联合用药组；单独用药组24例，其中阿司匹林组12例，氯吡格雷组12例。采用 TEG 检测花生四烯酸（AA）和二磷酸腺苷（ADP）途径诱导的血小板抑制率，并比较抗血小板治疗的效果。结果阿司匹林组的血小板抑制率为（65.95±20.41）%，高于氯吡格雷组的血小板抑制率（51.03±13.34）%，但其差异无统计学意义（P 〉0.05）；联合用药组 AA 诱导途径，ADP 诱导途径的血小板抑制率分别为（80.97±21.94）%和（58.02±23.92）%，联合用药组血小板抑制率高于单独用药组（P 〈0.05）；且抗血小板治疗的有效率高于单独用药组（ P 〈0.05）。结论联合用药抗血小板聚集作用优于单独用药组。通过血栓弹力图评价抗血小板疗效，指导临床对患者进行个性化用药具有一定价值。
Objective To evaluate the inhibitory effects of percutaneous coronary intervention（PCI）on platelet in patients taKing anti - platelet drugs by TEG in order to guide treatment adjustment in patients with anti - platelet aggregation. Methods 101 patients with coronary heart disease after PCI were selected. 77 patients were treated with aspirin and clopidogrel as the combination group,24 patients were treated with aspirin（aspirin group,12 cases）and clopidogrel（clopidogrel group,12 cases）alone. TEG was used to detect arachidonic acid（AA）- induced inhibition rate of platelet aggregation and adenosine diphosphate（ADP）receptor - induced inhibition rate of platelet aggrega-tion. The effects of anti - platelet therapy were compared. Results There was no significant difference in inhibition rates between aspirin group（61. 66 ± 21. 44）% and clopidogrel group（50. 26 ± 13. 21）% . The AA - induced and ADP - induced inhibition rates were（80. 97 ± 21. 94）% and（58. 02 ± 23. 92）% respectively in combined medica-tion group,which were higher than those in single drug group（P 〈 0. 05）. The effective rate of anti - platelet therapy in combined medication group was higher than that in single drug group（P 〈 0. 05）. Conclusion The effects of com-bined use of anti - platelet aggregation drugs are better than single drug. There is a certain value in evaluating inhibi-tory effects by TEG to guide personalized medication.
出处
《医学新知》
CAS
2016年第5期338-341,共4页
New Medicine
基金
湖北省自然科学基金（编号2015CKB741）
