崔同涛,于汇民,董太明,张斌,严红,乌汉东,廖洪涛,郭伟,靳立军

• 1:广东省人民医院心内科
• 2:广东省医学科学院
• 3:广东省心血管病研究所

摘要(Abstract)：

目的探讨以受试者工作特征曲线(ROC曲线)确定经皮冠状动脉介入治疗(PCI)术后高血小板聚集率(血小板低反应)与缺血性事件发生的关系。方法入选278例急性冠脉综合征(ACS)患者于PCI术后及随访期1个月分别行二磷酸腺苷(ADP)诱导血小板聚集率(ADP-PG)检测,观察院内围术期心肌梗死及术后6个月随访期内主要不良心脏事件(MACE);行ROC曲线分析,以最佳预测值分为血小板正常反应和血小板低反应组,观察组间MACE发生情况。结果 ROC曲线提示术后ADP-PG≥47.5%为血小板低反应组(曲线下面积=0.66,95% CI:0.57～0.75,P<0.01),共有81例(29.1%)患者;院内及6个月随访期共发生MACE39例(14.0%),随访期MACE发生率在血小板正常反应组和低反应组分别为4.6%(9/197)和11.1%(9/81),OR=2.61,P=0.04,低反应组更容易出现MACE。围术期心肌梗死在两组间分别为6.6%(13/197)和14.8%(12/81),OR=2.46,P=0.03,血栓性事件在两组间差异有统计学意义(P=0.03)。结论术后血小板低反应与PCI术后缺血性事件高发生率相关,监测ADP-PG对发现PCI术后高危人群有帮助。

关键词(KeyWords)： 血小板;急性冠状动脉综合征;支架;氯吡格雷;血栓形成

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金(81273599);; 广东省科技计划项目(2011A030300001);; 广东省自然科学基金(9151601501000007);; 广东省医学科研基金(A2010037)

作者(Author): 崔同涛,于汇民,董太明,张斌,严红,乌汉东,廖洪涛,郭伟,靳立军

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