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急性冠脉综合征患者冠脉介入治疗后氯吡格雷抵抗的临床观察
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| 篇名： | 急性冠脉综合征患者冠脉介入治疗后氯吡格雷抵抗的临床观察 |
| TITLE： | |
| 摘要： | 目的：探讨接受标准双联抗血小板治疗的急性冠脉综合征（ACS）患者冠脉介入治疗（PCI）后氯吡格雷抵抗发生率及可能的危险因素。方法：选取常规服用双联抗血小板药物（术前服用阿司匹林100 mg/d和氯吡格雷75 mg/d，连续5 d以上，或至少术前6 h给予阿司匹林300 mg和氯吡格雷300 mg负荷剂量，术后常规给予阿司匹林100 mg/d和氯吡格雷75 mg/d维持剂量）的住院接受PCI术的ACS患者93例，通过血栓弹力图（TEG）凝血分析仪测定其服用氯吡格雷抵抗发生率，并根据抑制率将患者分为抵抗组与非抵抗组，进行氯吡格雷抵抗相关危险因素分析。结果：氯吡格雷抵抗发生率为33.3％（31例）。氯吡格雷抵抗组的支架总长度、二磷酸腺苷激活血小板形成最大血凝块强度（MAADP）均显著长于非氯吡格雷抵抗组，差异均有统计学意义（P≤0.01）。结论：接受常规双联抗血小板药物治疗的经PCI术的ACS患者中，33.3％存在氯吡格雷抵抗。支架总长度、MAADP为发生氯吡格雷抵抗的危险因素。 |
| ABSTRACT： | OBJECTIVE：To explore the incidence and possible risk factors of clopidogrel resistance in patients of dual antiplatelet treatment with acute coronary syndrome （ACS） after percutaneous coronary intervention （PCI）. METHODS： A total of 93 ACS inpatients with dual antiplatelet drugs who underwent PCI （100 mg/d aspirin and 75 mg/d clopidogrel were given for more than 5 d before surgery， or loading dose of 300 mg aspirin and 300 mg clopidogrel 6 h before surgery， and loading dose of 100 mg/d aspirin and 75 mg/d clopidogrel were given after surgery） were enrolled， thromboelastography（TEG） was used to determine the platelet inhibition rate after giving clopidogrel，patients were divided into resistance group and non-resistance group based on the inhibition rate， and a related risk factors analysis was conducted for clopidogrel resistance. RESULTS：The incidence of clopidogrel resistance was 33.3％ （31 cases）. The total stent lengths and MAADP of clopidogrel resistance group were higher than non-clopidogrel resistance group，the difference was statistically significant（P≤0.01）. CONCLUSIONS： In the ACS patients with dual antiplatelet drugs who underwent PCI， 33.3％ show clopidogrel resistance. Total stent lengths and MAADP are the risk factors of clopidogrel resistance in ACS patients after PCI. |
| 期刊： | 2016年第27卷第9期 |
| 作者： | 陈云艳，顾智淳，叶东旭，沈珑 |
| AUTHORS： | CHEN Yunyan，GU Zhichun，YE Dongxu，SHEN Long |
| 关键字： | 急性冠脉综合征；冠脉介入治疗；血栓弹力图；氯吡格雷抵抗 |
| KEYWORDS： | Acute coronary syndrome； Percutaneous coronary intervention； Thromboelastography； Clopidogrel resistance |
| 阅读数： | 294 次 |
| 本月下载数： | 3 次 |
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