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冠心病患者支架置入术后监测血小板聚集率的临床意义 预览 被引量:13

Clinical significance of monitoring platelet aggregation in patient with coronary heart disease after stenting
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摘要 目的观察冠心病患者支架置入术后应用阿司匹林和氯吡格雷联合抗血小板治疗后,监测血小板聚集率并探讨其临床意义。方法测定562例冠心病患者,术前,术后3、7天,1、3、6个月二磷酸腺苷(ADP)和花生四烯酸(AA)诱导的血小板聚集率。ADP和从分别按照血小板抑制率〈40%和≥40%进行分组。ADP诱导血小板抑制率〈40%组(75例)和≥40%组(487例)。AA诱导血小板抑制率〈40%组(67例)和≥40%组(495例)。观察支架术后冠心病患者6个月的主要心脑血管事件。结果ADP和从诱导的血小板抑制率〈40%和≥40%两组分别比较一般临床资料,差异无显著性意义。随访6个月主要心脏事件的发生率:ADP诱导血小板抑制率〈40%组高于≥40%组(30.7%vs12.9%,P〈0.05);从诱导血小板抑制率〈40%组也高于≥40%组(28.1%vs11.7%,P〈0.05)。出血不良事件没有显著差异。结论冠心病患者支架置入术后的血小板抑制率与6个月的主要心脑血管事件相关。 Objective To observe platelet aggregation in patient with coronary heart disease(CHD) using aspirin and clopidogrel after stenting. Methods ADP-induced and AA-induced platelet aggregation in 562 patients before and 3,7 days, 1,3,6 months after coronary stenting was studied. The patients were divided into two groups according to ADP-and AA-induced platelet aggregation inhibition 〈 40% or 〉140%. There were 75 patients in one group with ADP-induced platelet aggregation inhibition 〈 40% and 487 patients in another group with ADP-induced platelet aggregation inhibition ≥40%. There were 67 patients in one group with AA-induced platelet aggregation inhibition 〈 40% and 495 patients in another group with AA-induced platelet aggregation inhibition 〉140%. The main cardiovasular and cerebrovascular events 6 months after coronary stenting were observed. Results The patients in the two groups had similar clinical feature and there was no difference in other index ( P 〉 0.05). The incidence of main cardiac events during 6-month follow-up was higher in the group with ADP-induced inhibition rate 〈 40% than in the group with inhibition rate≥40% (30.7% vs 12.9%, P 〈 0.05) The incidence was also higher in the group with AA-induced inhibition rate 〈 40% than in the group with inhibition rate ≥ 40 % (28.1% vs 11.7 %, P 〈 0. 05). The adverse event of bleeding was not different. Conclusion There is correlation between the platelet inhibition rate and main heart and brain vascular events in CHD patients during 6 months after stenting.
作者 芦燕玲 陈韵岱 吕树铮 LU Yan-ling, CHEN Ytm-dai, Lü Shu-zheng ( Anzhen Hospital, Beijing 100029, China)
出处 《中华老年心脑血管病杂志》 CAS 北大核心 2007年第2期 96-97,共2页 Chinese Journal of Geriatric Cardiovascular and Cerebrovascular Diseases
关键词 冠状动脉疾病 支架 血小板聚集 阿司匹林 血小板聚集抑制剂 coronary disease stents platelet aggregation aspirin platelet aggregation inhibitors
作者简介 芦燕玲,女,1970年6月生,北京市人,副主任医师,本科,从事心血管内科专业。
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参考文献5

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