介入治疗对冠心病患者血小板活化指标和抗血小板治疗效果及预后的影响研究

发布时间：2018-04-25 13:13

本文选题：冠心病 + 血小板活化　；参考：《中国全科医学》2017年33期

【摘要】：目的分析介入治疗对冠心病(CHD)患者血小板活化指标、抗血小板治疗效果及预后的影响。方法选取2014年7月—2015年6月华北理工大学附属医院心内科符合纳入标准的CHD患者270例,根据患者病情、冠状动脉造影结果及意愿,将患者分为非介入组124例(单纯药物治疗)、介入组146例(药物治疗+支架置入)。收集患者一般资料,检测两组患者血液生化指标、血小板活化指标及超敏C反应蛋白(hs-CRP),分析抗血小板治疗效果,记录主要不良心血管事件(MACE)发生率及再住院率。结果介入组患者6酮前列腺素F1a(PGF)较非介入组降低,P选择素(PS)、花生四烯酸(AA)诱导的最大血小板聚集率(MPAR),d TP及hs-CRP较非介入组升高(P0.05)。介入组患者抗血小板治疗效果劣于非介入组(P0.05)。非介入组患者MACE发生率(28.2%,35/124)与介入组(32.2%,47/146)比较,差异无统计学意义(P0.05)。非介入组患者再住院率(12.1%,15/124)与介入组(18.5%,27/146)比较,差异无统计学意义(P0.05)。结论介入治疗可促进血小板活化及炎性反应,诱发抗血小板药物抵抗,但并未增加MACE发生率及再住院率。对于接受介入治疗的CHD患者应该强化联合抗血小板治疗。
[Abstract]:Objective to analyze the effects of interventional therapy on platelet activation, antiplatelet therapy and prognosis in patients with coronary heart disease (CHD). Methods from July 2014 to June 2015, 270 patients with CHD who met the inclusion criteria in the Department of Cardiology, affiliated Hospital of Huabei Polytechnic University, were selected according to the patient's condition, coronary angiography results and willingness. The patients were divided into non-interventional group (n = 124) and interventional group (n = 146). The general data of patients were collected, and the blood biochemical indexes, platelet activation index and hypersensitive C-reactive protein hs-CRP were detected in the two groups. The effect of anti-platelet therapy was analyzed, and the incidence of major adverse cardiovascular events (MACEE) and the rate of readmission were recorded. Results compared with non-intervention group, 6-ketoprostaglandin F _ 1a PGF in the interventional group decreased the maximal platelet aggregation rate induced by P-selectin, arachidonic acid (AAA) and increased the level of MPARN, TP and hs-CRP in the intervention group compared with the non-intervention group. The effect of anti-platelet therapy in interventional group was worse than that in non-intervention group (P 0. 05). There was no significant difference in the incidence of MACE between the non-intervention group and the intervention group (P 0.05). No significant difference was found between the non-intervention group and the intervention group (P < 0.05). The rehospitalization rate of the non-intervention group was 12.1g / 124.Compared with that of the interventional group (18.5g / 146), there was no significant difference between the non-intervention group and the interventional group. Conclusion Interventional therapy can promote platelet activation and inflammatory reaction, induce anti-platelet drug resistance, but does not increase the incidence of MACE and the rate of readmission. For CHD patients undergoing interventional therapy, the combination of anti-platelet therapy should be enhanced.
【作者单位】：华北理工大学附属医院心血管内科;华北理工大学校医院内科;
【基金】：河北省卫生厅医学研究重点课题计划项目(20100474)
【分类号】：R541.4

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