【摘要】 目的研究冠心病患者经急诊皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)前后,二磷酸腺苷(adenosine diphosphate,ADP)及胶原(collagen,COL)诱导血小板聚集功能的变化及临床意义。方法抽取52例保守治疗的急性心肌梗死患者、38例行急诊冠状动脉造影(coronary angiography,CAG)的患者及46例行急诊PCI的患者,分别于入院服药(阿司匹林、氯吡格雷)后即刻(即术前)、服药后2 h(即术后)及服药后24 h采取静脉血,测定ADP及COL诱导的血小板聚集功能。结果 PCI组ADP及COL诱导的血小板的聚集功能在术后即刻较术前明显增加(P<0.01),服药后24 h较术后即刻降低但较术前增高(P<0.01);CAG组ADP诱导的血小板聚集功能在术后即刻及服药后24 h较术前明显降低,(P<0.01),而COL诱导的血小板的聚集性在各时段无明显改变;保守治疗组服药后2 h的ADP诱导的血小板聚集率较服药即刻下降(P<0.01),服药后24 h的ADP诱导的血小板聚集率较服药即刻及服药2 h明显下降(P<0.01),而COL诱导的血小板聚集率在各时段无明显改变。结论 ADP及COL诱导的血小板的聚集功能在PCI后明显增强,应加强抗血小板治疗以降低血小板聚集功能。更多还原

【Abstract】 Objective To investigate the changes and clinical significance of platelets aggregation rate induced by adenosine diphosphate(ADP) and collagen(COL) in patients with coronary heart disease before and after percutaneous transluminal coronary intravascular stent or intracoronary stent implantation.Methods Forty six patients underwent emergency percutaneous coronary intervention(PCI),38 patients underwent emergency coronary angiography(CAG) and 52 patients underwent regular medicine were analyzed platelet aggregation.All patients were treated with both aspirin and clopidogrel and their blood samples were taken to assayed at baseline(preoperative),2 h and postoperative 24 h.Results Group PCI:There was obvious increase in platelet aggregation rate induced by ADP and COL comparing postoperative ones instantly with preoperative ones(P<0.01).While lower than postoperative ones,24 h after drugs administration the platelet aggregation rate was much higher than preoperative ones;Group CAG:the ADP-induced platelet aggregation rate at postoperative and 24 h after drugs administration were lower than the baseline(P<0.01),whereas COL-induced platelets aggregation had no significant change;Groupexpectant treatment: the ADP-induced platelet aggregation rate at 2 h after drugs administration was lower than the baseline,and the ADP-induced platelet aggregation rate at 24 h after drugs administration was lower than the baseline and 2 h after drugs administration,whereas COL-induced platelets aggregation had no significant change.Conclusion The level of platelets aggregation rate induced by ADP and COL is increased significantly after coronary stent placement.It suggests that antiplatelet therapy should be strengthened to inhibit the platelets aggregation in patients after PCI.更多还原