CAJ | 학술논문

目的：使用血栓弹力图（TEG）检测急性冠状动脉综合征（ACS）患者分别服用国产氯吡格雷、阿司匹林和进口氯吡格雷、阿司匹林后对其血小板抑制情况分析。方法随机入选2012年7月至2013年7月在本院住院的适合行双重抗血小板治疗的ACS患者204例，随机分为国产氯吡格雷组（101例）及进口氯吡格雷组（103例），两组患者分别服用对应药物治疗5～7天后，使用TEG检测全血的血凝块强度及血小板功能。结果两组患者的基线资料及TEG检测时间无明显差异，国产氯吡格雷组患者TEG检测结果为全血交联的血凝块强度：（60.40±11.99）mm、二磷酸腺苷诱导的血凝块强度：（37.54±16.24）mm、二磷酸腺苷途径的血小板抑制率：（46.41±26.85）%、花生四烯酸诱导的血凝块强度：（31.81±16.06）mm、花生四烯酸途径的血小板抑制率：（56.18±28.29）%；进口氯吡格雷组患者TEG检测结果为全血交联的血凝块强度：（61.94±8.41）mm、二磷酸腺苷诱导的血凝块强度：（38.07±15.46）mm、二磷酸腺苷途径的血小板抑制：（48.07±26.17）%、花生四烯酸诱导的血凝块强度：（31.94±15.81）mm、花生四烯酸途径的血小板抑制率：（58.25±27.38）%，两组间血小板抑制功能的检测结果无差异（P＞0.05）。结论 ACS患者服用国产氯吡格雷、阿司匹林和进口氯吡格雷、阿司匹林进行双重抗血小板治疗后，应用TEG检测两种药物的抗血小板效果差异无显著性。
목적：사용혈전탄력도（TEG）검측급성관상동맥종합정（ACS）환자분별복용국산록필격뢰、아사필림화진구록필격뢰、아사필림후대기혈소판억제정황분석。방법수궤입선2012년7월지2013년7월재본원주원적괄합행쌍중항혈소판치료적ACS환자204례，수궤분위국산록필격뢰조（101례）급진구록필격뢰조（103례），량조환자분별복용대응약물치료5～7천후，사용TEG검측전혈적혈응괴강도급혈소판공능。결과량조환자적기선자료급TEG검측시간무명현차이，국산록필격뢰조환자TEG검측결과위전혈교련적혈응괴강도：（60.40±11.99）mm、이린산선감유도적혈응괴강도：（37.54±16.24）mm、이린산선감도경적혈소판억제솔：（46.41±26.85）%、화생사희산유도적혈응괴강도：（31.81±16.06）mm、화생사희산도경적혈소판억제솔：（56.18±28.29）%；진구록필격뢰조환자TEG검측결과위전혈교련적혈응괴강도：（61.94±8.41）mm、이린산선감유도적혈응괴강도：（38.07±15.46）mm、이린산선감도경적혈소판억제：（48.07±26.17）%、화생사희산유도적혈응괴강도：（31.94±15.81）mm、화생사희산도경적혈소판억제솔：（58.25±27.38）%，량조간혈소판억제공능적검측결과무차이（P＞0.05）。결론 ACS환자복용국산록필격뢰、아사필림화진구록필격뢰、아사필림진행쌍중항혈소판치료후，응용TEG검측량충약물적항혈소판효과차이무현저성。
Objective To evaluate the effects between domestic clopidogrel with aspirin and inport clopidogrel with aspirin on platelet inhibition in acute coronary syndrome (ACS) patients by thrombelastograph. Method 204 ACS patients ift for dual antiplatelet therapy in hospital were randomly selected from July 2012 to July 2013, and they were randomly divided into domestic clopidogrel group (101 cases) and imported clopidogrel group (103 cases), the two groups of patients taking corresponding drugs for 5 ~ 7 days. Then, test the clot strength and platelet function of the whole blood by thrombelastograph. Result The baseline data and thrombelastogram (TEG) detection time between the two groups had no signiifcant differences. In the domestic clopidogrel group, TEG test results of blood cross-linked clot strength:(60.40±11.99) mm, the clot strength induced by adenosine diphosphate:(37.54±16.24) mm, the platelet inhibition rate of adenosine diphosphate pathways:(46.41±26.85)%, the clot strength induced by arachidonic acid:(31.81±16.06) mm, the platelet inhibition rate of arachidonic acid pathways:(56.18±28.29)%. In the imported clopidogrel group, TEG test results of blood cross-linked clot strength:(61.94±8.41) mm, the clot strength induced by adenosine diphosphate:(38.07±15.46) mm, the platelet inhibition rate of adenosine diphosphate pathways:(48.07±26.17)%, the clot strength induced by arachidonic acid:(31.94±15.81) mm, the platelet inhibition rate of arachidonic acid pathways:(58.25±27.38)%. Between the two groups, platelet inhibition function showed no difference, P>0.05. Conclusion After dual antiplatelet therapy in patients with ACS, the TEG detection results of antiplatelet effects between domestic clopidogrel with aspirin group and inport clopidogrel with aspirin group had no signiifcant difference.