血栓弹力图在冠心病患者经皮冠状动脉介入术后抗血小板药物治疗中的应用价值

Application value of thromboelastography in antiplatelet drugs therapy after percutaneous coronary intervention of patients with coronary heart disease

目的探讨血栓弹力图在冠心病患者经皮冠状动脉介入(PCI)术后抗血小板药物治疗中的应用价值。方法根据治疗时间段的不同,将120例在本院进行PCI治疗的冠心病患者分为对照组(2019年6月至2019年11月,单一氯吡格雷或阿司匹林治疗)和观察组(2019年12月至2020年5月,氯吡格雷+阿司匹林治疗),各60例。两组治疗3 d后均进行血栓弹力图检测;比较两组的治疗效果。结果观察组出现药物抵抗的患者占比低于对照组(P<0.05)。观察组的R、CI、K、Angle、LY30高于对照组,MA低于对照组(P<0.05)。观察组的治疗总有效率高于对照组,高凝图形发生率、心脏不良事件总发生率低于对照组(P<0.05)。结论通过血栓弹力图能够评价冠心病患者PCI术后抗血小板药物的治疗效果,可促进抗血小板药物治疗方案的调整。

Objective To explore the application value of thromboelastography in antiplatelet drugs therapy after percutaneous coronary intervention(PCI)of patients with coronary heart disease.Methods According to different treatment periods,120 patients with coronary heart disease underwent PCI in our hospital were divided into control group(from June 2019 to November 2019,treated with single clopidogrel or aspirin)and observation group(from December 2019 to May 2020,treated with clopidogrel+aspirin),with 60 cases in each group.Thromboelastography was performed in both groups after 3 d of treatment;and the therapeutic effects of the two groups were compared.Results The proportion of patients with drug resistance in the observation group was lower than that in the control group(P<0.05).The R,CI,K,Angle and LY30 in the observation group were higher than those in the control group,and MA was lower than that in the control group(P<0.05).The total effective rate of treatment in the observation group was higher than that in the control group,and the incidence of hypercoagulable pattern and the total incidence of adverse cardiac events in the observation group were lower than those in the control group(P<0.05).Conclusion Thromboelastography can evaluate the therapeutic effect of antiplatelet drugs in patients with coronary heart disease after PCI,and promote the adjustment of antiplatelet drug treatment scheme.