冠心病患者介入术后血栓素B2与花生四烯酸诱导血小板聚集率的相关性研究

Relationship between plasma thromboxane B2 level and arachidonic acid-induced platelet aggregation in CHD patients after PCI

目的探讨PCI术后冠心病患者血浆血栓素B2水平及花生四烯酸诱导的血小板聚集率(PLAA)之间的相关性及其对患者临床不良心血管事件的影响。方法选择2015年1月～2016年6月于我院接受PCI的冠心病患者280例为研究对象,根据是否具有阿司匹林抵抗(aspirin resistance,AR)分为抵抗组29例和有效组251例,患者规律服用100mg阿司匹林肠溶片2周后,检测血浆血栓素B2水平和PLAA,出院后随访2年,记录患者的不良心血管事件发生情况。结果 280例冠心病患者中,AR发生率为10.36%。抵抗组患者血栓素B2水平和PLAA水平明显高于有效组,差异有统计学意义[(380.2±540.27)ng/L vs (267.19±38.73)ng/L,45.6(28.6,75.4)%vs 8.3(3.6,15.1)%,P<0.01]。冠心病患者血浆血栓素B2水平与PLAA呈正相关(r=0.487,P=0.002)。抵抗组总不良心血管事件发生率明显高于有效组,差异有统计学意义(31.03%vs 13.55%,P=0.013)。结论存在AR的冠心病患者PCI术后2年不良心血管事件发生率增加,预后较差,血浆血栓素B2水平与PLAA呈正相关关系,或可作为反映冠心病患者AR的一个有效指标。

Objective To study the relationship between plasma thromboxane B2(TXB2)level and arachidonic acid-induced platelet aggregation(PLAA)in CHD patients after PCI and its effect on MACE.Methods Two hundred and eighty CHD patients who underwent PCI in our hospital from January 2015 to June 2016 were divided into aspirin resistance(AR)group(n=29)and ARfree group(n=251).Two weeks after the patients were treated with 100 mg aspirin enteric-coated tablets,their plasma TXB2 level was measured and their PLAA rate was detected.The patients were followed up for 2 years after discharge,during which the incidence of MACE was recorded.Results The incidence of AR was 10.36%in AR group.The plasma TXB2 level and PLAA rate were significantly higher in AR group than in AR-free group(380.2±540.27 ng/L vs 267.19±38.73 ng/L,45.6%vs 8.3%,P<0.01).The plasma TXB2 level was positively related with the PLAA rate in CHD patients(r=0.487,P=0.002).The incidence of MACE was significantly higher in AR group than AR-free group(31.03%vs 13.55%,P=0.013).Conclusion The incidence of MACE is higher and the outcome is poorer in CHD patients with AR after 2 years of PCI.The plasma TXB2 level is positively related with the PLAA rate and can thus be used as an effective marker of AR in CHD patients.