吴瑛,张晓星,田蕾,蒋娟娟,许莉,黄一玲,刘红,李一石

• 1:卫生部心血管药物临床研究重点实验室中国医学科学院阜外医院心内科北京协和医学院

摘要(Abstract)：

目的探讨冠状动脉造影与支架置入术对腺苷二磷酸(ADP)诱导的血小板聚集率的影响。方法前瞻性纳入2012年5月1日至2013年4月30日中国医学科学院阜外医院冠心病患者343例,术前至少7 d连续服用阿司匹林100 mg,每日1次;氯吡格雷75 mg,每日1次。根据支架置入情况分为单纯冠状动脉造影组(造影组,173例)和支架置入组(170例)。患者在接受冠状动脉介入操作之前及之后24 h内,分别采集空腹血样本,用光学比浊法测定血小板聚集率,比较两组患者术前、术后血小板聚集率的变化,支架置入组有66例患者自愿参加血小板聚集率复测亚组分析。结果两组患者术前、术后血小板聚集率比较,差异无统计学意义(P>0.05);造影组患者术前、术后血小板聚集率比较,差异无统计学意义(P=0.062),而支架置入组患者术后血小板聚集率显著高于术前[(55.59±10.47)%比(52.47±11.97)%,P<0.001],差异有统计学意义;支架置入组患者术后血小板聚集率增加大于造影组[(3.12±8.31)%比(1.06±7.40)%,P=0.010],差异有统计学意义。随着患者支架置入数量的增加,术后血小板聚集率呈递增趋势,但差异无统计学意义(P>0.05)。支架置入组血小板聚集率复测亚组患者(66例)术后30 d血小板聚集率显著低于术后24 h[(54.71±11.64)%比(56.68±10.21)%,P=0.019],且与术前基线值比较,差异无统计学意义[(54.71±11.64)%比(54.26±12.23)%,P=0.901]。结论冠状动脉支架置入操作可导致术后血小板活性升高,该作用可在术后30 d内消失,而单纯冠状动脉造影则无此影响。

关键词(KeyWords)： 冠状动脉造影;支架置入术;血小板聚集

Abstract:

Keywords:

基金项目(Foundation): “重大新药创制”科技重大专项(2012ZX09303-008-001);; 2010年国家临床重点专科建设项目(《卫生部重点实验室项目》)

作者(Author): 吴瑛,张晓星,田蕾,蒋娟娟,许莉,黄一玲,刘红,李一石

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