血栓弹力图在老年急性冠脉综合征患者抗血小板治疗有效性与安全性评估中的应用

Evaluation of Effectiveness and Safety of Thrombelastogram in Antiplatelet Therapy in Treatment of Elderly Patients with Acute Coronary Syndrome

目的:探讨血栓弹力图在老年急性冠脉综合征患者抗血小板治疗临床评估中的应用效果。方法:选取2016年3月-2017年3月本院治疗的60例老年急性冠脉综合征患者,均实施常规抗血小板治疗。治疗72 h之后,根据胸痛情况分为胸痛缓解组(36例),胸痛未缓解组(24例)。对两组患者均实施血栓弹力图检查,并比较检查结果。结果:治疗后,两组心肌肌钙蛋白水平均出现显著的下降,差异均有统计学意义(P<0.05)。但治疗前与治疗后两组组间比较,差异均无统计学意义(P>0.05)。胸痛缓解组的阿司匹林血小板抑制率显著高于胸痛未缓解组,差异有统计学意义(P<0.05)。两组在R、K、α角、MA、氯吡格雷血小板抑制率、凝血指数方面比较,差异均无统计学意义(P>0.05)。结论:对接受抗血小板治疗的老年急性冠脉综合征患者实施血栓弹力图检测可以客观反映治疗后患者的血小板聚集抑制率变化情况,可指导抗血小板药物的临床应用,有助于减少临床缺血事件的发生。

Objective：To investigate the effect of clinical application of thrombelastogram in antiplatelet therapy in the treatment of elderly patients with acute coronary syndrome.Method：A total of 60 elderly patients with acute coronary syndrome in our hospital from March 2016 to March 2017 were treated by conventional antiplatelet therapy.After 72 h treatment,all were divided into chest pain remission group（36 cases）and chest pain non-remission group（24 cases）according to chest pain.The two groups were given thrombelastogram,and the results of the examination were compared.Result：After treatment,the cardiac troponin levels of the two groups were significantly decreased than before treatment,the differents were statistically significant（P〈0.05）.There were no statistically significant before and after the treatment between the two groups（P〈0.05）.The aspirin platelet inhibition rate in the chest pain remission group was higher than that in the chest pain non-remission group,the different was statistically significant（P〈0.05）.There were no statistically significant in R,K,MA,alpha angle,clopidogrel platelet inhibition rate,blood coagulation index between the two groups（P〉0.05）.Conclusion：The thrombelastogram in antiplatelet therapy in the treatment of elderly patients with acute coronary syndrome can objectively reflect inhibitory rate of blood platelet aggregation after treatment,guide the antiplatelet drug and contribute to reduce the incidence of clinical ischemic events.