尿酸对男性急性冠状动脉综合征患者PCI术后抗血小板效应的影响

Effect of uric acid on antiplatelet effect in male patients with acute coronary syndrome after PCI

目的探讨尿酸对男性急性冠状动脉综合征(ACS)患者经皮冠状动脉介入(PCI)术后抗血小板效应的影响。方法按照尿酸水平,将2018年1-12月在该院行PCI术的160例男性ACS患者分为高尿酸组(72例)与正常尿酸组(88例)。PCI术后所有患者均口服硫酸氢氯吡格雷片(每次75 mg,每日1次)和阿司匹林片(每次100 mg,每日1次)。服药1周后采用VerifyNow血小板功能检测仪测定2组的血小板聚集率,计算血小板高反应性(血小板聚集率>46%)。采用血栓弹力图仪测定2组的花生四烯酸抑制率及二磷酸腺苷抑制率。观察2组主要心血管不良事件的发生情况。结果高尿酸组三酰甘油及肌酐水平均明显高于正常尿酸组(P<0.05),高密度脂蛋白胆固醇水平明显低于正常尿酸组(P<0.05)。高尿酸组的血小板聚集率[(43.58±7.22)%]及血小板高反应性[56.94%(41/72)]均明显高于正常尿酸组[(34.17±5.65)%、20.45%(18/88)],差异有统计学意义(P<0.05)。高尿酸组的花生四烯酸抑制率[(48.25±8.87)%]及二磷酸腺苷抑制率[(35.19±6.22)%]均明显低于正常尿酸组[(66.32±10.43)%、(60.44±9.17)%],差异有统计学意义(P<0.05)。高尿酸组的主要心血管不良事件发生率[16.67%(12/72)]明显高于正常尿酸组[4.55%(4/88)],差异有统计学意义(P<0.05)。结论高尿酸男性ACS患者PCI术后抗血小板作用减弱,效应降低。

Objective To investigate the effect of uric acid on antiplatelet effect in male patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI).Methods According to the level of uric acid,160 male ACS patients undergoing PCI in the hospital from January to December 2018 were divided into high uric acid group(72 cases)and normal uric acid group(88 cases).All patients were given clopidogrel tablets(75 mg/time,1 time/d)and aspirin tablets(100 mg/time,1 time/d)after PCI.The platelet aggregation rate of the two groups was measured by VerifyNow platelet function tester one week after taking the medicine,and the platelet high reactivity(platelet aggregation rate>46%)was calculated.The inhibition rates of arachidonic acid and adenosine diphosphate were measured by thromboelastography.The main adverse cardiovascular events were observed in two groups.Results The levels of triacylglycerol and creatinine in high uric acid group were significantly higher than those in normal uric acid group(P<0.05),and the levels of HDL-C were significantly lower than those in normal uric acid group(P<0.05).The platelet aggregation rate[(43.58±7.22)%vs.(34.17±5.65)%]and platelet hyperresponsiveness[56.94%(41/72)vs.20.45%(18/88)]of high uric acid group was significantly higher than that of normal uric acid group(P<0.05).The inhibition rate of arachidonic acid[(48.25±8.87)%vs.(66.32±10.43)%]and the inhibition rate of adenosine diphosphate[(35.19±6.22)%vs.(60.44±9.17)%]of high uric acid group was significantly lower than that of normal uric acid group(P<0.05).The incidence of main adverse cardiovascular events[16.67%(12/72)vs.4.55%(4/88)]in high uric acid group was significantly higher than that of normal uric acid group(P<0.05).Conclusion The antiplatelet effect was weakened after PCI in male ACS patients with high uric acid.