刘松涛,蔡新勇,邵靓,刘员员,黄笑,朱虹岷,洪浪,詹宇亮

• 1:江西省人民医院(南昌医学院第一附属医院)心内科

摘要(Abstract)：

目的 探讨经导管主动脉瓣置换术（TAVR）术后血小板减少发生规律及相关因素。方法 选取2021年1月至2022年12月在江西省人民医院行TAVR患者111例，依据术后血小板减少较基线值≥30%分为术后血小板减少组及术后血小板正常组。对比两组病例资料，分析TAVR术后血小板减少的发生规律及相关因素。结果 在111例TAVR患者中，术后血小板减少组72例（64.9%），其中80.5%患者在术后第2～4天血小板计数降低至最低值，94.4%患者出院前血小板计数恢复基线水平；术后血小板正常组39例（35.1%）。术后血小板减少组与术后血小板正常组患者中术后白细胞计数[（12.69±3.74）×10~9/L比（10.00±3.48）×10~9/L,P<0.001]、术后中性粒细胞百分比[（87.51±6.52）%比（79.60±11.01）%,P<0.001]、术后血红蛋白[（94.50±18.30）g/L比（108.80±17.50）g/L,P <0.001]、术后血小板计数[（89.38±42.26）×10~9/L比（14 4.21±4 0.0 4）×10~9/L,P <0.0 0 1]、术后C反应蛋白[（3 4.8 4±4 0.2 5）m g/L比（12.59±10.94）mg/L,P=0.048]、术后降钙素原[（1.55±3.81）ng/ml比（0.24±0.24）ng/ml,P=0.020]、手术时间[（132.85±25.05）min比（115.13±10.48）min,P<0.001]比较，差异均有统计学意义。经二元Logistic单因素回归方程分析，手术时间是TAVR术后血小板减少的影响因素，差异有统计学意义（OR 1.062,95%CI 1.028～1.098,P<0.001）。结论 TAVR术后发生血小板减少是一种常见的现象，且具有自限性，大部分患者在出院前血小板能恢复至基线水平。炎症反应可能是TAVR术后血小板减少的潜在机制。较长的手术时间与术后血小板减少独立相关。

关键词(KeyWords)： 经导管主动脉瓣置换术;血小板减少

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 刘松涛,蔡新勇,邵靓,刘员员,黄笑,朱虹岷,洪浪,詹宇亮

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