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
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