冠脉支架置入术后支架内狭窄尿毒症患者的外周血血栓弹力图观察

发布时间：2018-03-17 06:34

  本文选题：尿毒症　切入点：维持血液透析　出处：《山东医药》2017年23期 　论文类型：期刊论文

【摘要】：目的观察冠脉支架置入术后发生支架内狭窄的尿毒症患者外周血血栓弹力图检查结果的变化,探讨合并冠心病的尿毒症患者冠脉支架置入术后发生支架内狭窄的原因。方法选择冠脉支架置入术后1年内发生支架内再狭窄的尿毒症患者37例为观察组,冠脉支架置入术后1年内无支架内再狭窄的尿毒症患者34例为对照组。两组患者术后均坚持服用氯吡格雷75 mg/d抗血小板。观察组患者确诊支架内狭窄、对照组患者随访结束后,血液透析前1 d,空腹采集外周静脉血。行血栓弹力图(TEG)检查,检测血栓最大弹力度(MA值)和血小板二磷酸腺苷(ADP)受体抑制率。结果观察组、对照组MA分别为64.6±5.7、58.9±5.4,血小板ADP受体抑制率分别为44.4%±13.3%、54.2%±12.3%。两组MA和血小板ADP受体抑制率相比,P均0.05。结论冠脉支架置入术后狭窄的尿毒症患者外周血TEG检查结果 MA升高、血小板ADP受体抑制率下降。合并冠心病的尿毒症患者冠脉支架置入术后发生支架内狭窄的原因可能是氯吡格雷抵抗导致的血小板高反应。
[Abstract]:Objective to observe the changes of thromboelastography in peripheral blood of uremia patients with stent stenosis after coronary stenting. To investigate the causes of in-stent stenosis in uremic patients with coronary heart disease after coronary stenting. Methods 37 uremic patients with restenosis within one year after coronary stenting were selected as the observation group. 34 patients with uremia without stent restenosis within one year after coronary stent implantation were taken as control group. The patients in both groups were treated with clopidogrel 75 mg/d anti-platelet. The patients in the observation group were diagnosed with stent stenosis and the control group was followed up. One day before hemodialysis, peripheral venous blood was collected on an empty stomach. Thromboelastography (TEG) was performed to detect the maximal elasticity of thrombus (MA) and the inhibition rate of platelet adenosine diphosphate (ADPP) receptor. In the control group, MA was 64.6 卤5.7 卤58.9 卤5.4, and the inhibition rate of platelet ADP receptor was 44.4% 卤13.33.34.2% 卤12.3.The inhibition rate of MA and platelet ADP receptor in the two groups was 0.055.Conclusion the TEG examination of peripheral blood of uremic patients with stenosis after coronary stenting is higher than that of control group. In uremic patients with coronary heart disease, the cause of stent stenosis after coronary stenting may be the high platelet reaction caused by clopidogrel resistance.
【作者单位】： 中国人民解放军第161医院;
【基金】：全军医学科技青年培育项目(13QNP196)
【分类号】：R692.5
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本文编号：1623590