【摘要】 目的研究PCI术后,通过血栓弹力图(thromboela-stogram,TEG)测定ADP诱导的血小板抑制率来指导患者长期抗凝药物应用的可行性。方法选取2009年1月~2013年8月在我院接受PCI治疗的患者,术后常规应用抗血小板药物1周后采血测定ADP诱导的血小板抑制率,大于70%的患者纳入A组,再将小于30%的样本用随机数字表法分为B和C组,B组给予大剂量抗凝药物长期治疗,A组和C组维持常规用量,随访6个月,观察三组患者心脏不良事件(major adverse cardiac event,MACE)的发生情况。结果三组患者随访后的ADP诱导的血小板抑制率存在显著性差异(χ2=6.528,P=0.017),且B和C两组差异显著(χ2=4.157,P=0.036);随访期间MACE发生率,χ2检验显示三组之间存在明显差异(χ2=4.032,P=0.041),并且B和C两组差异亦有统计学意义(χ2=4.216,P=0.031)。结论 TEG测定ADP诱导的血小板抑制率指标,对PCI术后患者的抗血小板凝集药物的应用方案具有重要的指导意义,能够有效减少MACE发生,改善患者预后。更多还原

【Abstract】 Objective To observe the rate of ADP-induced platelet inhibition after PCI by thromboelastography( TEG),to guide the feasibility in patients with long-term of anticoagulation applications. Methods Choosing patients in our hospital who received PCI treatment from January 2009 to August 2013,measure the rate of ADP-induced platelet inhibition by blood test after surgery routine use of antiplatelet drugs of 1 week. patients with the rate of ADP-induced platelet inhibition more than 70% were included in group A,and then less than 30% of the samples were randomly divided into groups B and C. Group B was given large doses of longterm anticoagulant therapy,group A and C maintain conventional dosage. Follow-up of six months,three groups of patients were observed the incidence of major adverse cardiac events. Results Follow-up of six months,there was a significant difference in the rate of ADP-induced platelet inhibition among three groups patients( χ2= 6. 528,P = 0. 017),and group B and group C were significantly different( χ2= 4. 157,P = 0. 036); there was a significant difference in the MACE rate among three groups( χ2= 4. 032,P =0. 041),and group B and group C were significantly different( χ2= 4. 216,P = 0. 031). Conclusion TEG measure ADP-induced platelet inhibition rate is significant to guide antiplatelet drug applications for patients after surgery,can effectively reduce the incidence of MACE,improve patient prognosis.更多还原