摘要
目的:采用血栓弹力图评估经皮冠状动脉介入治疗(PCI)患者服用抗血小板药物后血小板抑制效果。方法:选择2011-05-2015-04治疗的168例冠心病患者为研究对象,以其中56例接受PCI治疗并联合服用阿司匹林与氯吡格雷的患者作为联合用药组,56例未接受PCI治疗单独服用阿司匹林的患者为阿司匹林组,56例未接受PCI治疗单独服用氯吡格雷的患者为氯吡格雷组。采用血栓弹力图检测花生四烯酸(AA)和二磷酸腺苷(ADP)途径诱导的血小板抑制率,并分析抗血小板药物敏感性的相关因素。结果:1联合用药组与阿司匹林组的AA途径血小板抑制率比较差异无统计学意义(P>0.05);联合用药组与氯吡格雷组的ADP途径抑制率也差异无统计学意义(P>0.05);2阿司匹林的敏感性与吸烟、肥胖、高脂血症、糖尿病有关(P<0.05),氯吡格雷敏感性与性别、吸烟、肥胖及糖尿病有关(P<0.05)。结论:采用血栓弹力图可以及时发现对抗血小板药物不敏感的患者,从而有利于制定个体化的抗血小板治疗方案。
Objective：To assess the effects of antiplatelet agents using thrombelastography in patients with percutaneous coronary intervention（PCI）.Method：A total of 168 patients with coronary heart disease in our hospital between May 2011 and April 2015 were enrolled in this study.Among them,56 patients who treated with PCI and took aspirin and clopidogrel were chosen as combination group,56 patients who did not receive PCI and took aspirin only as aspirin group and 56 cases who did not receive PCI and took clopidogrel only as clopidogrel group.The platelet inhibition rates induced by arachidonic acid（AA）pathway and adenosine diphosphate（ADP）pathway were detected by thrombelastography,and the related factors influencing the sensitivity of antiplatelet drugs were analyzed.Result：1The platelet inhibition rates induced by AA pathway was no significant difference（P〉0.05）between combination group and aspirin group,and the rates induced by ADP pathway was no significant difference（P〉0.05）between combination group and clopidogrel group.2The sensitivity of aspirin was associated with smoking,obesity,hyperlipidemia and diabetes（P〈0.05）,and the sensitivity of clopidogrel was related to gender,smoking,obesity and diabetes（P〈0.05）.Conclusion：The patients who were insensitive to antiplatelet agents could be found in a timely manner by thrombelastography,thus to formulate individualized antiplatelet therapies.
出处
《临床血液学杂志（输血与检验）》
CAS
2016年第1期120-122,共3页
Journal of Clinical Hematology(Blood Transfusion & Laboratory Medicine)
