血栓弹力图在缺血性脑卒中患者抗血小板药物选择中的应用

Application of thrombelastogram in choosing antiplatelet drug for patients with cerebral arterial thrombosis

目的:探究血栓弹力图(TEG)在缺血性脑卒中患者选择抗血小板药物中的应用价值。方法:选取100例新发缺血性脑卒中患者,在急性期14 d经双抗治疗(阿司匹林和氯吡格雷)后改为单抗治疗,根据选择药物的方法不同,随机将患者分为观察组和对照组,每组50例。对照组患者随机选择单抗药物,而观察组患者根据TEG结果选择较为敏感的药物抗血小板治疗,随访观察两组患者缺血性卒中的复发情况。结果:在1年内,观察组缺血性卒中复发率为6%(3/50),明显低于对照组的20%(10/50),两组脑卒中复发率比较差异有统计学意义(x^2=4.332,P<0.05),而每组内服不同的药物卒中复发率无显著差别。结论:TEG技术能够有效评估抗血小板治疗的效果,指导药物的选择,从而降低卒中复发率。

Objective:To investigate the application value of thromboelastography(TEG)in choosing antiplatelet drug for patients with cerebral arterial thrombosis.Methods:100new patients with cerebral arterial thrombosis,who received single antiplatelet therapy after received dual antiplatelet therapy(aspirin and clopidogrel)in acute stage(14d),were randomly divided into observation group(50cases)and control group(50cases).According to different method of choosing drug,patients of control group randomly were implemented different single antiplatelet drug,while patients of observation group received more sensitive antiplatelet drug based on TEG results.The follow-up observation about recurrent situation of cerebral arterial thrombosis for the two groups were carried out in further study.Results:In one year,the recurrence rate of cerebral arterial thrombosis of observation group(6%,3/50)was significantly lower than that of control group(20%,10/50)(x2=4.332,P<0.05).The differences of recurrence rate between different antiplatelet drug in intra-group were not statistically significant.Conclusion:TEG can efficiently evaluate the therapeutic effect of antiplatelet drug,and guide the selection for drug so as to reduce the recurrence rate of cerebral arterial thrombosis.