氯吡格雷在急性脑梗死的糖尿病患者中血小板抑制效应的研究

发布时间：2018-04-26 03:23

本文选题：血栓弹力图 + 型糖尿病　；参考：《中风与神经疾病杂志》2017年07期

【摘要】：目的用血栓弹力图(thromboelastograms,TEG)评价合并糖尿病的急性脑梗死患者正规使用氯吡格雷后血小板抑制率的变化及氯吡格雷抵抗情况。方法收集住院的急性脑梗死患者80例,其中糖尿病患者33例,非糖尿病患者47例,所有患者予以顿服氯吡格雷负荷量300 mg继以75 mg/d维持,在服用氯吡格雷3 d后和7 d后空腹抽取肘静脉血标本,用血栓弹力图(thromboelastograms,TEG)测定10μmol/L二磷酸腺苷(adenosine diphosphate,ADP)受体途径诱导的血小板抑制率,分析比较两组患者临床特征、血小板抑制率的差异和氯吡格雷抵抗情况。结果糖尿病组的空腹血糖(Fasting plasma glucose,FPG)和糖化血红蛋白(%)显著高于非糖尿病组,差异具有统计学意义(P0.05)。糖尿病组3 d后和7 d的血小板抑制率显著低于非糖尿病组,差异具有统计学意义(P0.05)。糖尿病组3 d和7 d后分别有11例(33.3%)、12例(36.4%)患者出现氯吡格雷抵抗的现象,显著高于非糖尿病组的6例(12.8%)、5例(10.6%),差异具有统计学意义(P0.05)。结论糖尿病患者的血小板抑制率明显低于非糖尿病患者,更容易发生氯吡格雷抵抗现象。
[Abstract]:Objective to evaluate the changes of platelet inhibition rate and clopidogrel resistance in patients with acute cerebral infarction complicated with diabetes mellitus by thromboelastography. Methods 80 inpatients with acute cerebral infarction were collected, including 33 diabetic patients and 47 non-diabetic patients. All patients were treated with clopidogrel 300mg and maintained at 75 mg/d. After taking clopidogrel for 3 days and 7 days, the blood samples of cubital vein were taken on an empty stomach. Thromboelastography was used to determine the platelet inhibition rate induced by 10 渭 mol/L adenosine diphosphate ADPP-receptor pathway, and the clinical characteristics of the two groups were analyzed and compared. Differences in platelet inhibition rates and clopidogrel resistance. Results fasting plasma glucose and glycosylated hemoglobin in diabetic group were significantly higher than those in non-diabetic group (P 0.05). The platelet inhibition rate in the diabetic group was significantly lower than that in the non-diabetic group after 3 days and 7 days, and the difference was statistically significant (P 0.05). There were 11 patients with clopidogrel resistance in diabetes group 3 days and 7 days later, 12 patients with 36.4% clopidogrel resistance, which was significantly higher than that in non-diabetic group (P 0.05). Conclusion the platelet inhibition rate of diabetic patients is significantly lower than that of non-diabetic patients and clopidogrel resistance is more likely.
【作者单位】：潍坊市人民医院;
【基金】：基金项目:潍坊市科技局(No.2016YX019)
【分类号】：R587.1;R743.3

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