应用TEG评价PCI术后患者发生氯吡格雷反应低下的影响因素

发布时间：2018-06-22 18:49

本文选题：血栓弹力图 + 氯吡格雷　；参考：《首都医科大学》2017年硕士论文

【摘要】：目的利用血栓弹力图(Thromboelastograph,TEG)评价在经皮冠状动脉介入治疗(Percutaneous Coronary Intervention,PCI)术后的冠心病患者中,发生氯吡格雷反应低下的影响因素。方法选取接受PCI的冠心病患者158例,术前1天均予口服负荷剂量阿司匹林300mg和氯吡格雷300mg抗血小板治疗,次日晨起空腹时接受血栓弹力图检查,以二磷酸腺苷(adenosine diphosphate,ADP)诱导的血小板聚集抑制率小于30%为氯吡格雷反应低下,比较氯吡格雷反应低下与氯吡格雷非反应低下患者的临床资料、生化指标及影像学参数,通过Logistic回归分析氯吡格雷反应低下的危险因素。结果总计78例患者出现氯吡格雷反应低下,发生率为49.4%。两组患者在性别构成、糖尿病史方面的差异有统计学意义(P0.05),在其余各项生化指标及影像学参数的差异均无统计学意义(P0.05)。Logistic回归分析结果显示氯吡格雷反应低下的独立危险因素包括女性(P=0.003,OR=2.807,95%CI=1.406~5.605)以及糖尿病史(P=0.033,OR=2.061,95%CI=1.059~4.011)。结论女性及糖尿病史可能是冠心病患者PCI术后发生氯吡格雷反应低下的危险因素。
[Abstract]:Objective to evaluate the risk factors of low clopidogrel response in patients with coronary heart disease after percutaneous coronary intervention (PCI) with thromboelastography (TEG). Methods 158 patients with coronary heart disease who received PCI were given antiplatelet therapy with aspirin 300mg and clopidogrel 300mg one day before operation, and thromboelastography was performed on an empty stomach the next morning. The inhibition rate of platelet aggregation induced by adenosine diphosphate was lower than 30%. The clinical data, biochemical indexes and imaging parameters of patients with low clopidogrel reaction and clopidogrel non-response were compared. Logistic regression analysis was used to analyze the risk factors of low clopidogrel reaction. Results there were 78 patients with low clopidogrel reaction (49.4%). Two groups of patients in the gender composition, There were significant differences in the history of diabetes mellitus (P0.05), but there was no significant difference in other biochemical and imaging parameters (P0.05). Logistic regression analysis showed that the independent risk factors for low clopidogrel reaction included women (P0. 003 OR2.807 + 95CII 1.4065.605) and diabetes history (P0.033 OR2.061 95CII 1.0594.011). Conclusion the history of women and diabetes may be the risk factors of low clopidogrel reaction after PCI in patients with coronary heart disease.
【学位授予单位】：首都医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.4

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