血栓弹力图在缺血性脑卒中抗血小板治疗中的应用

发布时间：2018-03-05 02:02

本文选题：血栓弹力图　切入点：缺血性脑卒中　出处：《标记免疫分析与临床》2016年02期 　论文类型：期刊论文

【摘要】：目的探讨血栓弹力图(thrombelastogram,TEG)在指导缺血性脑卒中抗血小板治疗中的应用价值。方法选择2014年1月至2015年3月于我院住院治疗的初发缺血性脑卒中患者为研究对象,排除应用抗血小板药物禁忌症后,随机分为试验组和对照组。两组均给予改善血液循环、清除自由基、抗血小板聚集(阿司匹林肠溶片100mg/d)及对症等治疗。对照组不行TEG检测,试验组口服阿司匹林1周后应用TEG检测花生四烯酸(AA)途径诱导的血小板抑制率,对阿司匹林抵抗患者改口服氯吡格雷(波立维75mg/d),1周后应用TEG检测腺苷二磷酸(ADP)受体途径诱导的血小板抑制率,观察血小板抑制率改善情况。对存活出院的患者进行随访,观察两组缺血性脑卒中复发及其他血管事件发生情况。结果(1)行TEG检测的100例患者中有43例存在阿司匹林抵抗,改为氯吡格雷后血小板抑制率由(27.24±11.32)%提高到(41.70±21.51)%,但仍有17例患者同时存在氯吡格雷抵抗。(2)随访6~15个月后试验组缺血性脑卒中复发率明显低于对照组(6.3%vs 16.8%),差异有统计学意义(P0.05)。结论 TEG可指导缺血性脑卒中患者抗血小板治疗,从而降低缺血性脑卒中复发率。
[Abstract]:Objective to investigate the value of thromboelastin thrombolysis in guiding antiplatelet therapy of ischemic stroke. Methods patients with primary ischemic stroke who were hospitalized in our hospital from January 2014 to March 2015 were selected as study objects. After exclusion of contraindications of antiplatelet drugs, they were randomly divided into two groups: the experimental group and the control group. Both groups were treated with improved blood circulation, free radical scavenging, anti-platelet aggregation (aspirin enteric-coated tablets 100mg / d) and symptomatic therapy. The control group was not able to detect TEG. The platelet inhibition rate induced by arachidonic acid (AA) pathway was detected by TEG after oral aspirin for 1 week in the trial group. The platelet inhibition rate induced by adenosine diphosphate receptor pathway was detected by TEG in aspirin resistant patients after oral administration of clopidogrel (75 mg / d) a week later. The improvement of platelet inhibition rate was observed. The patients who were discharged from hospital were followed up. The recurrence of ischemic stroke and the occurrence of other vascular events were observed in two groups. Results 43 of the 100 patients with TEG were found to have aspirin resistance. The platelet inhibition rate was increased from 27.24 卤11.32% to 41.70 卤21.51%, but clopidogrel resistance was found in 17 patients.) after 6-15 months follow-up, the relapse rate of ischemic stroke in the trial group was significantly lower than that in the control group (6.3g vs 16.8g). Conclusion TEG can direct antiplatelet therapy in patients with ischemic stroke. So as to reduce the recurrence rate of ischemic stroke.
【作者单位】：廊坊长征医院神经内三科;
【分类号】：R743.3

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