CAJ | 학술논문

目的探讨经皮冠状动脉介入治疗(PCI)患者术后,应用血栓弹力图(TEG)监测的血小板抑制率,合理选择应用二联抗血小板药物或三联抗血小板药物.方法经本院收治的冠脉支架植入术患者300例,术后均为常规方法给予抗血小板药物治疗,应用美国Hamoscope公司的TEG分析仪测定ADP途径诱导的血小板抑制率,患者分为抑制率达标及抑制率未达标,选取未达标患者60随机分为2组,Ⅰ组为硫酸氢氯吡格雷(波利维)+阿司匹林,加用西洛他唑(即三联抗血小板组)；另1组为硫酸氢氯吡格雷(波利维)+阿司匹林(二联抗血小板组).2组患者均随访3个月,记录随访期间不良缺血事件的发生情况.结果二联组与三联组两组间患者PCI术后第3天血小板ADP抑制率差异无统计学意义,二联组(10.8±3.3)%,三联组(11.4±3.9)%；术后1个月复查血小板ADP抑制率,二联组(10.2±6.6)%,三联组(55.7±16.8)%,两组间差异存在明显差异(P<0.05),具有统计学意义.结论血栓弹力图(TEG)测定的血小板抑制率,对冠脉支架植入术后患者选择抗血小板药物治疗具有一定的临床价值.
목적탐토경피관상동맥개입치료(PCI)환자술후,응용혈전탄력도(TEG)감측적혈소판억제솔,합리선택응용이련항혈소판약물혹삼련항혈소판약물.방법경본원수치적관맥지가식입술환자300례,술후균위상규방법급여항혈소판약물치료,응용미국Hamoscope공사적TEG분석의측정ADP도경유도적혈소판억제솔,환자분위억제솔체표급억제솔미체표,선취미체표환자60수궤분위2조,Ⅰ조위류산경록필격뢰(파리유)+아사필림,가용서락타서(즉삼련항혈소판조)；령1조위류산경록필격뢰(파리유)+아사필림(이련항혈소판조).2조환자균수방3개월,기록수방기간불량결혈사건적발생정황.결과이련조여삼련조량조간환자PCI술후제3천혈소판ADP억제솔차이무통계학의의,이련조(10.8±3.3)%,삼련조(11.4±3.9)%；술후1개월복사혈소판ADP억제솔,이련조(10.2±6.6)%,삼련조(55.7±16.8)%,량조간차이존재명현차이(P<0.05),구유통계학의의.결론혈전탄력도(TEG)측정적혈소판억제솔,대관맥지가식입술후환자선택항혈소판약물치료구유일정적림상개치.
Objective: To explore the objective status of platelet inhibition ratio determined by thrombelastoglapby(TEG) in patients who have undergone percutaneous coronary intervention(PCI), in order to reasonably choose dual antiplatelet drugs or triple antiplatelet drugs.Methods: 300 patients who have undergone coronary stent implantation in our hospital were all treated with antiplatelet drugs in conventional methods. ADP induced platelet inhibition ratio should be detected by TEG (USA, Hamoscope). On the basis of the results,all the patients were divided to meet standard group and substandard group. 60 patients of the substandard group was choosed randomly and divided into two groups: groupI of aspirin and clopidngrel combined witll cilostazol (triple antiplatelet drugs group) and groupII of aspirin and clopidogrel (dual antiplatelet drugs group). Both groups were received 3-month clinical follow-up visit to definite adverse ischemia events. Results:Three days after PCI, the incidence rates of ischcmia events of dual antiplatelet drugs group and triple antiplatelet drugs group respectively are (10.8±3.3)% and (11.4±3.9)%, which is of no statistical significance. One month after PCI, the incidence rates of ischcmia events of dual antiplatelet drugs group and triple antiplatelet drugs group respectively are (10.2± 6.6)% and (55.7±16.8)%. The two groups exist significant difference (P<0.05) and are of significantly statistical difference. Conclusion: Platelet inhibition ratio determined by TEG is of clinical value for the selection of treatment prescription of antipaltelet drugs for PCI patients.