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目的研究血小板聚集率检测水平与行经皮冠脉介入(percutancous coronary intervention,PCI)术后患者心血管不良事件的相关性。方法用比浊法和阻抗法检测119例行PCI术服用阿司匹林和氯吡格雷超过7 d的患者的血浆或全血的血小板聚集率,促凝剂分别为终浓度为5μmo/lL的ADP或终浓度为2 mg/L的胶原。1年后随访,用SPSS13.0对未发生心血管不良事件及发生心血管不良事件组的患者的血小板聚集率平均值进行统计学分析。结果 13例发生心肌缺血等心血管不良事件组患者以ADP为促凝剂比浊法测定的血小板聚集率平均值(0.63±0.12),与未发生心血管不良事件组患者的血小板聚集率平均值(0.48±0.18)比较,差异有统计学意义(P<0.05);两组患者以胶原为促凝剂阻抗法检测的血小板聚集率平均值(分别为8.3±3.8和5.2±3.3)比较,差异有统计学意义。两组患者以ADP为促凝剂阻抗法测定的血小板聚集率平均值,及以胶原为促凝剂比浊法检测的血小板聚集率平均值比较差异无统计学意义。结论以ADP为促凝剂比浊法,及以胶原为促凝剂阻抗法检测的血小板聚集率,与行PCI术常规服用阿司匹林和氯吡格雷抗血小板药的患者是否易发生心血管不良事件,有一定的相关性。
Objective To study the correlation between the level of platelet aggregation and cardiovascular adverse events after percutaneous coronary intervention (PCI). Methods The turbidimetric method and impedance method were used to detect the platelet aggregation rate in plasma or whole blood in 119 patients who underwent PCI with aspirin and clopidogrel for more than 7 days. The coagulant was ADP at the final concentration of 5μmol / lL Collagen at a concentration of 2 mg / L. Follow-up one year later, SPSS13.0 statistical analysis of mean platelet aggregation in patients without cardiovascular adverse events and cardiovascular adverse events. Results The average platelet aggregation rate (0.63 ± 0.12) measured by ADP as coagulant turbidimetry in 13 patients with cardiovascular events such as myocardial ischemia was significantly lower than that in patients without cardiovascular adverse events (0.48 ± 0.18), the difference was statistically significant (P <0.05). The average platelet aggregation rate (8.3 ± 3.8 and 5.2 ± 3.3) The difference was statistically significant. There was no significant difference between the two groups in terms of average platelet aggregation rate measured by ADP as coagulant impedance method and platelet aggregation rate detected by collagen as coagulant turbidimetry. Conclusion ADP as coagulant nephelometry, and collagen as coagulant impedance test platelet aggregation rate, and conventional PCI with aspirin and clopidogrel antiplatelet drugs in patients prone to cardiovascular adverse events, A certain degree of relevance.