1例经皮冠状动脉介入治疗术后支架内血栓形成患者治疗的病例分析

A case analysis of one patient with in-stent thrombosis after percutaneous coronary intervention

本文分析1例经皮冠状动脉介入治疗(PCI)术后支架内血栓形成患者的治疗方案,为临床由于药物原因引起的支架内血栓形成提供参考。该患者冠脉支架置入1年后发生支架内再狭窄。药师对患者使用药物进行分析,发现与氯吡格雷抵抗有关。建议对患者进行基因多态性检查,结果显示患者为慢代谢型,建议将氯吡格雷更换为替格瑞洛,更换替格瑞洛后查血小板聚集率达标,说明抗血小板治疗有效。临床药师通过对患者使用药品的分析为临床提供用药参考。

In this paper,the treatment of a patient with in-stent thrombosis after percutaneous coronary intervention(PCI)was analyzed in order to provide reference for in-stent thrombosis caused by drugs.The patient developed in-stent restenosis 1 year after coronary stent implantation.The pharmacist analyzed the patient′s drugs and found that it was related to Clopidogrel resistance.It is suggested that the patients should be examined for gene polymorphism.The results showed that the patient was slow metabolic type.It is suggested that Clopidogrel should be replaced with tigrel,and the platelet aggregation rate can reach the standard after replacement of tigrel,indicating that antiplatelet therapy was effective.Clinical pharmacists provide reference for clinical through the analysis of drugs used by patient.