摘要
目的:使用血栓弹力图观察银杏叶片对冠心病患者PCI术前、术后抗血小板抑制功能的影响,为PCI患者合理应用抗血小板药物提供理论依据。方法:60名患者随机分为联合用药组30例、常规对照组30例。入组患者均在入组时、术后3月使用血栓弹力图测量血小板功能(AA途径、ADP途径的血小板抑制率),同时使用血栓弹力图测量凝血风险指标(ADPMA值);所有患者检测干预前后肝肾功能,对其安全性进行判定。结果:2组患者的基线资料基本相似,随访3月时,与常规对照组相比,联合用药组的肝肾功能未见明显改变,两者相比无统计学差异(P>0.05)。术后3月,2组患者AA途径检测的血小板抑制率与服药前相比有增高趋势,无统计学差异,且2组间也无差异(P>0.05);2组患者ADP途径检测的血小板抑制率与入组时相比有明显升高,均有统计学差异(联合用药组,用药前vs.术后3月:45.1±4.7%vs.59.3±4.1%,P=0.036;常规对照组,用药前vs.术后3月:50.8±3.7%vs.74.4±3.5%,P=0.014);2组间相比,无统计学差异。入组3个月后,联合用药组ADPMA值(反应患者的凝血倾向)较服药前有所下降,常规对照组ADPMA值较服药前显著上升(联合用药组,用药前vs.术后3月:40.3±2.9mmvs.31.6±2.7mm,P=0.028);常规对照组,服药前vs.术后3月:37.3±2.8mmvs.64.4±0.8mm,P<0.001)。结论:银杏叶片可安全的应用于PCI术患者,服用银杏叶片不会影响抗血小板药物的功效,可以一定程度上降低患者凝血风险。
Objective:Observe the effect of ginkgo biloba leaves on the anti-platelet inhibitory function of patients with coronary heart disease before and after PCI using thrombus elastograms,and to provide theoretical basis for the rational application of anti-platelet drugs in patients with PCI.Methods:60 patients were randomly divided into 30 cases in the combination group and 30 cases in the conventional control group.Thromboelastic map was used to measure platelet function(platelet inhibition rate by AA pathway and ADP pathway)at the time of enrollment and 3 months after surgery,and clotting risk indicators(ADPMA values)were also measured using TEG.All patients were tested for liver and kidney function before and after intervention to determine their safety.Results:The baseline data of patients in the two groups were basically similar.At the following 3 months,there was no significant change in liver and kidney function between the two groups compared with the conventional control group,and there was no statistical difference between the two groups(P>0.05).Three months after surgery,the platelet inhibition rate detected by AA pathway in the two groups showed an increased trend compared with that before the medication,with no statistical difference,and there was no difference between the two groups(P<0.05).The platelet inhibition rate detected by ADP pathway in both groups was significantly higher than that detected at the time of enrollment,with statistically significant differences(in the combined treatment group,pre-medication vs.postoperative 3 months:45.1+4.7%vs.59.3+4.1%,P=0.036).Control group:50.8+3.7%vs.74.4+3.5%,P=0.014);There was no statistical difference between the two groups.After 3 months of enrollment,the ADPMA value(reflecting the clotting tendency of the patients)in the combination group was lower than that before medication.The ADPMA value in the conventional control group was significantly higher than that before medication,(the combination group:40.3 2.9mm Vs.31.6 2.7mm,P=0.028).Control group:37.3 2
作者
徐佑龙
李清丽
刘宗军
Xu Youlong;Li Qingli;Liu Zongjun(Department of Cardiology,The Putuo Affiliated Hospital of Shanghai University of Traditional Chinese Medicine,Shanghai,200062,China)
出处
《成都中医药大学学报》
2019年第2期44-48,共5页
Journal of Chengdu University of Traditional Chinese Medicine
基金
上海市卫计委医学重点专科建设项目(ZK2015A17)
