河北中医
河北中醫
하북중의
HEBEI JORNAL OF TRADITIONAL CHINESE MEDICINE
2015年
1期
149-151,152
,共4页
支架%动脉瘤%血小板聚集抑制剂%血栓弹力描记术
支架%動脈瘤%血小闆聚集抑製劑%血栓彈力描記術
지가%동맥류%혈소판취집억제제%혈전탄력묘기술
Stenting,Arterial aneurysm%Platelet aggregation inhibitors%Thrombelastogram
目的:通过应用血栓弹力图监测二磷酸腺苷( ADP)途径诱导的血小板抑制率(简称ADP抑制率),研究颅内外动脉支架成形术患者术后抗血小板治疗的临床疗效。方法选取200例行颅内外动脉支架成形术者,术后常规应用阿司匹林和氯吡格雷双抗治疗,血栓弹力图测定其ADP抑制率,根据抑制率分为3组,抑制率≥70%为反应良好组(设定为A组)96例,抑制率≤30%病例104例,分为2组,每组各52例(分别设定为B、C组),B组保持阿司匹林和氯吡格雷常规剂量治疗不变,C组加大阿司匹林和氯吡格雷剂量,连续随访6个月,记录3组一般情况及严重颅内血管不良事件发生情况。结果3组患者一般情况比较差异无统计学意义(P>0.05)。随访6个月中,共发生不良事件31例,其中A组8例(8.33%),B组12例(23.08%), C组8例(15.38%),A组不良事件发生率低于B、C组(P<0.05),C组低于B组(P<0.05)。3组病例不良事件的发生在术后1个月较高,但与其他月份间比较差异无统计学意义(P>0.05)。结论血栓弹力图监测在颅内外动脉支架成形术患者抗血小板治疗的过程中,对不良事件发生的预测及抗血小板治疗药物剂量调整有一定的指导意义。
目的:通過應用血栓彈力圖鑑測二燐痠腺苷( ADP)途徑誘導的血小闆抑製率(簡稱ADP抑製率),研究顱內外動脈支架成形術患者術後抗血小闆治療的臨床療效。方法選取200例行顱內外動脈支架成形術者,術後常規應用阿司匹林和氯吡格雷雙抗治療,血栓彈力圖測定其ADP抑製率,根據抑製率分為3組,抑製率≥70%為反應良好組(設定為A組)96例,抑製率≤30%病例104例,分為2組,每組各52例(分彆設定為B、C組),B組保持阿司匹林和氯吡格雷常規劑量治療不變,C組加大阿司匹林和氯吡格雷劑量,連續隨訪6箇月,記錄3組一般情況及嚴重顱內血管不良事件髮生情況。結果3組患者一般情況比較差異無統計學意義(P>0.05)。隨訪6箇月中,共髮生不良事件31例,其中A組8例(8.33%),B組12例(23.08%), C組8例(15.38%),A組不良事件髮生率低于B、C組(P<0.05),C組低于B組(P<0.05)。3組病例不良事件的髮生在術後1箇月較高,但與其他月份間比較差異無統計學意義(P>0.05)。結論血栓彈力圖鑑測在顱內外動脈支架成形術患者抗血小闆治療的過程中,對不良事件髮生的預測及抗血小闆治療藥物劑量調整有一定的指導意義。
목적:통과응용혈전탄력도감측이린산선감( ADP)도경유도적혈소판억제솔(간칭ADP억제솔),연구로내외동맥지가성형술환자술후항혈소판치료적림상료효。방법선취200례행로내외동맥지가성형술자,술후상규응용아사필림화록필격뢰쌍항치료,혈전탄력도측정기ADP억제솔,근거억제솔분위3조,억제솔≥70%위반응량호조(설정위A조)96례,억제솔≤30%병례104례,분위2조,매조각52례(분별설정위B、C조),B조보지아사필림화록필격뢰상규제량치료불변,C조가대아사필림화록필격뢰제량,련속수방6개월,기록3조일반정황급엄중로내혈관불량사건발생정황。결과3조환자일반정황비교차이무통계학의의(P>0.05)。수방6개월중,공발생불량사건31례,기중A조8례(8.33%),B조12례(23.08%), C조8례(15.38%),A조불량사건발생솔저우B、C조(P<0.05),C조저우B조(P<0.05)。3조병례불량사건적발생재술후1개월교고,단여기타월빈간비교차이무통계학의의(P>0.05)。결론혈전탄력도감측재로내외동맥지가성형술환자항혈소판치료적과정중,대불량사건발생적예측급항혈소판치료약물제량조정유일정적지도의의。
Objective To study clinical efficacy of antiplatelet therapy in intracranial and extracranial carot -id artery stent patients by monitoring platelet inhibition rate with thrombelastograph .Methods Select 200 cases of intracranial and extracranial carotid artery stent patients treated by our hospital from January 2012 to December 2013 , routinely being used double -antibody therapy after surgery .Thrombelastograph measures platelet inhibition rate in-duced by adenosine diphosphate ( ADP) ,and divide these cases into three groups according to the inhibition rate .The cases of inhibition rate ≥70%is the qualified group ( group A) including 96 cases,the cases of inhibition rate ≤30%are divided into two groups ,each group includes 52 cases,group B keeps on conventional dose therapy ,group C increases the dose .Follow up for six months continually ,record general data and adverse events of intracranial vascular adverse events.Result During follow-up of six months,there were 31 cases of adverse events,8 cases of group A (8. 33%),12 cases of group B (23.08%),8 cases of group C (15.38%).Incidences of adverse effect in group A was lower than that in group B and C (P<0.05).That of group C was lower than that of group B (P<0.05).The occur-rence of adverse events in three groups was higher at one month and six months after surgery .Conclusion Throm-belastograph monitors the process of antiplatelet therapy to intracranial and extracranial artery stenting patients ,it has certain leading significance to the prediction of adverse events and dose adjustment of antiplatelet drugs .