血栓弹力图分析抗血小板药物治疗的冠心病患者经皮冠状动脉介入后血液高凝状态和缺血事件的价值

Value of thromboelastography in analyzing blood hypercoagulability and ischemic events after percutaneous coronary intervention in coronary heart disease patients with anti-platelet drug therapy

  • 摘要:
      目的  探讨血栓弹力图(TEG)分析抗血小板药物治疗的冠心病(CHD)患者经皮冠状动脉介入(PCI)后血液高凝状态和缺血事件的价值。
      方法  选取118例行PCI的CHD患者为研究对象,根据术后是否采取TEG分为TEG组和常规组,比较2组患者TEG检测结果和凝血指标水平,观察术后6个月缺血事件和出血事件发生情况。
      结果  TEG组和常规组临床资料比较,差异无统计学意义(P>0.05)。TEG组凝血反应时间(R)、血凝块形成时间(K)、花生四烯酸(AA)抑制率和二磷酸腺苷(ADP)抑制率高于常规组,而血凝块形成速率(α角)和血块最大振幅(MA)低于常规组,差异均有统计学意义(P < 0.05)。TEG组凝血酶原时间(PT)、纤维蛋白原(FIB)低于常规组,而活化部分凝血活酶时间(APTT)、凝血酶时间(TT)高于常规组,差异有统计学意义(P < 0.05)。2组患者术后6个月缺血事件发生率、出血事件发生率比较,差异有统计学意义(P < 0.05)。
      结论  TEG指导抗血小板药物治疗有利于CHD患者PCI后快速改善血液高凝状态,可降低CHD患者PCI后缺血事件、出血事件的发生率。

     

    Abstract:
      Objective  To investigate the value of thromboelastography (TEG) in analyzing blood hypercoagulability and ischemic events after percutaneous coronary intervention (PCI) in coronary heart disease (CHD) patients with anti-platelet drug therapy.
      Methods  A total of 118 CHD patients with PCI were selected as objects, and they were divided into TEG group and routine group according to whether TEG was taken after operation. The result of TEG and coagulation indexes were compared between the two groups, and the incidence of ischemic events and bleeding events at 6 months after surgery was observed.
      Results  There were no significant differences in clinical materials between the TEG group and routine group (P>0.05). The coagulation reaction time (R), kinetics of clot development (K), inhibition rates of arachidonic acid (AA) and adenosine diphosphate (ADP) in the TEG group were significantly higher than those in the routine group, while the speed of blood clot formation (α angle) and maximum amplitude of clot (MA) were significantly lower than those in the routine group (P < 0.05). Prothrombin time (PT) and fibrinogen (FIB) in the TEG group were significantly lower than those in the routine group, while activated partial thromboplastin time (APTT) and thrombin time (TT) were significantly higher than those in routine group (P < 0.05). There were significant differences in the incidence rates of ischemic events and bleeding events at 6 months after operation between the two groups (P < 0.05).
      Conclusion  TEG-guided anti-platelet drug therapy is beneficial to the rapid improvement of blood hypercoagulability after PCI in CHD patients, which can reduce the incidence rates of ischemia and bleeding events after PCI in CHD patients.

     

/

返回文章
返回