血小板聚集抑制率评估冠心病行PCI术患者的血小板高反应性

发布时间：2018-05-05 22:45

本文选题：血小板聚集抑制率 + 冠心病　；参考：《实用医学杂志》2017年20期

【摘要】：目的采用血小板聚集抑制率(inhibition of platelet aggregation,IPA)评估冠心病经皮冠状动脉介入术(PCI)后双联抗血小板患者的血小板反应性。方法冠心病患者第1天或PCI术前服用负荷剂量氯吡格雷300 mg,第2天起或PCI术后开始服用维持剂量氯吡格雷(75 mg/d)同时口服阿司匹林(100mg/d),至少1年。检测并计算患者服用负荷剂量氯吡格雷前后的IPA,根据IPA将患者分为血小板高反应组(HPR组)和低反应组(LPR组),观察两组患者术后1年的心血管事件的再发生率。结果本研究纳入102例患者,男77例,女25例,平均(65.7±10.9)岁,其中HPR组69例,LPR组33例,HPR组的平均IPA值明显低于LPR组(P0.01)。HPR组和LPR组12个月末的心血管事件累积发生率分别为15.9%和3.0%,HPR组明显高于LPR组(P0.05)。结论 IPA可用于评估患者血小板反应性,建议临床医师在双联抗血小板时常规检测IPA,并据此制定个体化治疗方案,减少心血管事件的发生。
[Abstract]:Objective to evaluate the platelet reactivity of patients with coronary heart disease after percutaneous coronary intervention (PCI) with inhibition of platelet aggregation (IPA). Methods patients with coronary heart disease were given the loading dose of clopidogrel 300 mg / d before the first day or PCI and the maintenance dose of clopidogrel 75 mg / d from the second day or after PCI) and aspirin 100mg / d for at least one year. IPAs before and after loading dose of clopidogrel were detected and calculated. The patients were divided into two groups according to IPA: high platelet response group (IPA group) and low response group (LPR group). The recurrence rate of cardiovascular events in both groups was observed one year after operation. Results 102 patients (77 males and 25 females) were included in this study, with an average age of 65.7 卤10.9 years. The mean IPA value of HPR group (69 cases) was significantly lower than that of LPR group (P 0.01). The cumulative incidence of cardiovascular events in LPR group was 15.9% and 3.0% respectively at the end of 12 months, which was significantly higher than that in LPR group (P 0.05). Conclusion IPA can be used to evaluate the platelet reactivity of patients. It is suggested that clinicians should routinely detect it during dual antiplatelet therapy and formulate individualized treatment regimen to reduce the occurrence of cardiovascular events.
【作者单位】：江苏省苏北人民医院药学部;江苏省苏北人民医院血研所;江苏省苏北人民医院心内科;
【基金】：江苏省“六大人才高峰”资助项目(编号:2016-WSN-280) 扬州市科技发展指导计划课题(编号:YZCZSYJJ1403)
【分类号】：R541.4

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