摘要
目的探讨冠心病患者行经皮冠状动脉介入术(percutaneous coronary intervention,PCI)后服用复方丹参滴丸在改善阿司匹林和/或氯吡格雷低反应性中的作用。方法冠心病患者409例,PCI术后规律服用阿司匹林、氯吡格雷,并给予复方丹参滴丸270 mg/次,3次/d,口服,连续2个月。分别于治疗2 d及2个月行血栓弹力图检查(thrombelastography,TEG),测量花生四烯酸(arachidonic acid,AA)诱导的血小板抑制率(AA%)、二磷酸腺苷(adenosine diphosphate,ADP)诱导的血小板抑制率(ADP%),观察不良反应发生情况。结果治疗2个月AA%[(84.77±5.69)%]、ADP%[(76.67±6.87)%]水平高于治疗2d[(77.34±5.41)%、(64.81±6.20)%](P<0.05);治疗2d筛查出AA%<50%者59例,ADP%<50%者133例;AA%<50%者治疗2个月AA%[(81.25±4.96)%]较治疗2d[(21.40±5.23)%]增高(P<0.05),52例AA%>50%;ADP%<50%者治疗2个月ADP%[(75.66±6.08)%]较治疗2d[(32.19±4.56)%]增高((P<0.05),109例ADP%>50%;治疗过程中均未发生脑出血、消化道出血。结论复方丹参滴丸可改善冠心病患者PCI术后血小板对阿司匹林/或氯吡格雷的低反应性。
Objective To investigate the effect of compound Danshen dropping pill on low response of platelet to aspirin or elopidogrel after percutaneous coronary intervention （PCI） in patients with coronary heart disease. Methods A total of 409 patients with coronary heart disease received oral administration of compound Danshen Dipping pills 270 mg per time, three times a day, totally for 2 months, besides the routine administration of aspirin or elopidogrel after PCI. All patients underwent thrombelastography （TEG） to detect the arachidonic acid （AA） inhibition rate to asprin （AA%） and the adenosine diphosphate （ADP） inhibition rate to clopidogrel （ADP%） after 2-day and 2-month treatment. The incidence of adverse reaction was observed. Results The AA% and ADP% were significantly higher after 2 month treatment （（84.77± 5.69） %, （77.34±5.41）%） than those after 2-day treatment （（64.81±6.20）%, （76.67±6.87）%） （P〈0.05）. TEG showed AA% was 〈50% in 59 patients and ADP% was 〈50% in 133 patients after 2-day treatment. AA% was significantly higher after 2-month treatment （（81.25 ± 4.96）% ） than that after 2-day treatment （（21.40 ±5.23）%） in those AA%50% （P〈0.05）. And in 59 patients of AA%〈50%, AA% was 〉50% after 2-month treatment. ADP% was significantly higher after 2-month treatment （（75.66 ± 6.08）%） than that after 2-day treatment （（32. 194±4.56）%） in those of ADP%〈50% （P〈0.05）. And in 133 patients with ADP%〈50%, ADP% was 〉50% after 2-month treatment. No complications occurred as cerebral hemorrhage or gastrointestinal bleeding. Corlclusion Compound Danshen dripping pill can improve the low response of platelet to aspirin or clopidogrel after PCI in patients with coronary heart disease.
出处
《中华实用诊断与治疗杂志》
2017年第1期79-81,共3页
Journal of Chinese Practical Diagnosis and Therapy
基金
上海市中医药三年行动计划项目(CC-3-3040)
关键词
冠心病
经皮冠状动脉介入术
复方丹参滴丸
血小板低反应性
血小板抑制率
Coronary heart disease
percutaneous coronary intervention
compound Danshen dropping pill
low platelet reactivity
platelet inhibition rate
