血栓弹力图在冠心病介入术后抗血小板治疗中的应用效果分析
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摘要
目的分析血栓弹力图在冠心病介入(PCI)术后抗血小板治疗中的应用价值。方法选取2017年11月至2018年7月100例医院收治的行PCI治疗患者作为观察对象,并根据患者的病情状况分为A组(稳定性心绞痛)、B组(不稳定性心绞痛)和C组(急性心肌梗死),AB两组均为30例,C组为40例。所有患者均行血栓弹力图以及凝血功能检测,比较3组各指标,并统计抗血小板药物反应低下患者与反应正常患者心脏不良事件的发生率。结果 A、B、C组的R、K、LY30、APTT、TT、INR指标呈逐渐下降的趋势(P<0.05),而Angle、MA、CI、FIB、D-D指标呈逐渐升高的趋势(P<0.05);B、C两组血栓弹力图检测中高凝图形的发生率明显高于A组(P<0.05),B组血栓弹力图检测中高凝图形的发生率明显低于C组(P<0.05);抗血小板药物反应低下患者三个月内心脏不良事件发生率明显高于抗血小板药物反应正常患者(P<0.05)。结论血栓弹力图在冠心病介入术后抗血小板治疗中具有较好的应用价值,能够指导患者的临床用药,从而降低心脏不良事件的发生率。
Objective To evaluate the application of thrombus elastography in anti-platelet therapy after PCI. Methods From November 2017 to July 2018, 100 patients admitted to the hospital for PCI treatment were selected as the observation objects, and according to the condition of the patients, they were divided into group A(stable angina pectoris), group B(unstable angina pectoris) and group C(acute myocardial infarction), with 30 cases in group AB and 40 cases in group C. All patients underwent thrombolysis elastography and coagulation function test, and the indicators of the three groups were compared, and the incidence of adverse cardiac events in patients with low response to antiplatelet drugs and those with normal response were calculated. Results R, K, LY30, APTT, TT, INR of group A, B and C showed A decreasing trend(P<0.05), while Angle, MA, CI, FIB,d-d showed A rising trend(P<0.05). The incidence of hypercoagulation pattern in the detection of thrombus elastograms in group B and C was significantly higher than that in group A(P<0.05), and the incidence of hypercoagulation pattern in the detection of thrombus elastograms in group B was significantly lower than that in group C(P<0.05). The incidence of adverse cardiac events in patients with low antiplatelet drug response was significantly higher than that in patients with normal antiplatelet drug reaction within three months(P<0.05). Conclusion Thrombolysis elastography has a good application value in anti-platelet therapy after coronary heart disease intervention, and can guide the clinical medication of patients, so as to reduce the incidence of adverse cardiac events.
Objective To evaluate the application of thrombus elastography in anti-platelet therapy after PCI. Methods From November 2017 to July 2018, 100 patients admitted to the hospital for PCI treatment were selected as the observation objects, and according to the condition of the patients, they were divided into group A(stable angina pectoris), group B(unstable angina pectoris) and group C(acute myocardial infarction), with 30 cases in group AB and 40 cases in group C. All patients underwent thrombolysis elastography and coagulation function test, and the indicators of the three groups were compared, and the incidence of adverse cardiac events in patients with low response to antiplatelet drugs and those with normal response were calculated. Results R, K, LY30, APTT, TT, INR of group A, B and C showed A decreasing trend(P<0.05), while Angle, MA, CI, FIB,d-d showed A rising trend(P<0.05). The incidence of hypercoagulation pattern in the detection of thrombus elastograms in group B and C was significantly higher than that in group A(P<0.05), and the incidence of hypercoagulation pattern in the detection of thrombus elastograms in group B was significantly lower than that in group C(P<0.05). The incidence of adverse cardiac events in patients with low antiplatelet drug response was significantly higher than that in patients with normal antiplatelet drug reaction within three months(P<0.05). Conclusion Thrombolysis elastography has a good application value in anti-platelet therapy after coronary heart disease intervention, and can guide the clinical medication of patients, so as to reduce the incidence of adverse cardiac events.
引文
[1]陶格斯,牛瑞兵,张静,等.血栓弹力图检测在急性心肌梗死患者中的应用研究[J].当代医学,2017,23(30):55-57.
[2]杨霄,杨国强,郭娟,等.血栓弹力图分析非体外循环冠状动脉旁路移植术围术期的凝血功能[J].当代医学,2016,22(32):40-41.
[3]赵树武,王玉平,徐林东,等.血栓弹力图在冠心病抗血小板治疗中的临床应用[J].中国循证心血管医学杂志,2014,45(3):328-330.
[4]龚艳君,邱林,屈晨雪,等.血栓弹力图评价冠状动脉介入治疗术后抗血小板药物疗效及与预后的关系[J].中华全科医学,2016,14(8):1289-1292.
[5]张华巍,杨庭树.血栓弹力图在冠状动脉介入治疗患者抗血小板治疗中的应用研究[J].中国循证心血管医学杂志,2015,5(1):46-47.
[6]王热华,林锋,陈诗泉,等.血栓弹力图评估阿司匹林和氯吡格雷血小板抑制率的临床应用[J].中国老年学杂志,2015,33(17):4111-4112.
[7]杨宁,赵翠,付莉,等.血小板功能检测指导冠心病合并2型糖尿病择期冠脉介入治疗患者抗血小板治疗的研究[J].中国慢性病预防与控制,2015,23(8):600-602.
[8]苗林子,陆遥,屈晨雪,等.冠心病患者经皮冠状动脉介入治疗术后抗血小板药物治疗监测及平均血小板体积变化[J].临床检验杂志,2017,35(6):439-443.
[9]袁萍莉.应用血栓弹力图指导冠心病患者介入治疗术后抗血小板治疗的临床价值[J].血栓与止血学,2017,23(5):772-774.
[10]张兵兵,唐海沁,张勇,等.血栓弹力图评价冠心病患者抗血小板药物治疗的临床疗效[J].中国临床保健杂志,2015,34(4):370-372.
[11]詹晓燕,林玉蓓,胡杰,等.血栓弹力图监测冠心病患者PCI术后替格瑞洛和氯吡格雷抗血小板治疗效果研究[J].中国循证心血管医学杂志,2017,9(9):1108-1111.
[12]孙阿林,庞军涛,马长虹,等.应用血栓弹力图评估不同抗血小板药物在老年冠心病患者中的疗效及对策[J].中国医药导报,2016,13(32):69-72.
[2]杨霄,杨国强,郭娟,等.血栓弹力图分析非体外循环冠状动脉旁路移植术围术期的凝血功能[J].当代医学,2016,22(32):40-41.
[3]赵树武,王玉平,徐林东,等.血栓弹力图在冠心病抗血小板治疗中的临床应用[J].中国循证心血管医学杂志,2014,45(3):328-330.
[4]龚艳君,邱林,屈晨雪,等.血栓弹力图评价冠状动脉介入治疗术后抗血小板药物疗效及与预后的关系[J].中华全科医学,2016,14(8):1289-1292.
[5]张华巍,杨庭树.血栓弹力图在冠状动脉介入治疗患者抗血小板治疗中的应用研究[J].中国循证心血管医学杂志,2015,5(1):46-47.
[6]王热华,林锋,陈诗泉,等.血栓弹力图评估阿司匹林和氯吡格雷血小板抑制率的临床应用[J].中国老年学杂志,2015,33(17):4111-4112.
[7]杨宁,赵翠,付莉,等.血小板功能检测指导冠心病合并2型糖尿病择期冠脉介入治疗患者抗血小板治疗的研究[J].中国慢性病预防与控制,2015,23(8):600-602.
[8]苗林子,陆遥,屈晨雪,等.冠心病患者经皮冠状动脉介入治疗术后抗血小板药物治疗监测及平均血小板体积变化[J].临床检验杂志,2017,35(6):439-443.
[9]袁萍莉.应用血栓弹力图指导冠心病患者介入治疗术后抗血小板治疗的临床价值[J].血栓与止血学,2017,23(5):772-774.
[10]张兵兵,唐海沁,张勇,等.血栓弹力图评价冠心病患者抗血小板药物治疗的临床疗效[J].中国临床保健杂志,2015,34(4):370-372.
[11]詹晓燕,林玉蓓,胡杰,等.血栓弹力图监测冠心病患者PCI术后替格瑞洛和氯吡格雷抗血小板治疗效果研究[J].中国循证心血管医学杂志,2017,9(9):1108-1111.
[12]孙阿林,庞军涛,马长虹,等.应用血栓弹力图评估不同抗血小板药物在老年冠心病患者中的疗效及对策[J].中国医药导报,2016,13(32):69-72.
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