龚艳君,屈晨雪,邱林,杨帆,王智,龚岩,袁家颖,李建平,刘兆平,洪涛

• 1:北京大学第一医院心内科
• 2:北京大学第一医院检验科

摘要(Abstract)：

目的应用改良血栓弹力图(thrombelastography,TEG)测定不同诱导剂诱导下的血小板抑制率,分析经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后患者氯吡格雷及阿司匹林低反应的发生率,并分析可能的影响因素。方法入选2013年3月至2014年5月在北京大学第一医院行PCI并接受规范双联抗血小板治疗的患者184例,采用改良TEG的方法分别测定静脉全血、腺苷二磷酸(adenosine diphosphate,ADP)诱导及花生四烯酸(arachidonic acid,AA)诱导的TEG最大幅度(MA),计算血小板抑制率。将ADP诱导的血小板抑制率<30%定义为氯吡格雷低反应,AA诱导的血小板抑制率<50%定义为阿司匹林低反应。收集临床及实验室资料,进行分析。结果所有患者中,有65例(35.3%)存在阿司匹林低反应,63例(34.2%)存在氯吡格雷低反应,32例(17.4%)同时存在阿司匹林及氯吡格雷低反应。年龄、冠心病分型、是否合并高血压或糖尿病未影响抗血小板药物低反应的发生率。临床用药方面,质子泵抑制剂使用与否未影响抗血小板药物低反应的发生率,使用不同种类他汀类药物的患者抗血小板药物的反应相似。结论 TEG检测的抗血小板药物低反应发生率较高,常规临床因素对其影响尚未明确,需引起临床医师的关注。

关键词(KeyWords)： 经皮冠状动脉介入治疗;氯吡格雷低反应;阿司匹林低反应;血栓弹力图

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 龚艳君,屈晨雪,邱林,杨帆,王智,龚岩,袁家颖,李建平,刘兆平,洪涛

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