血栓弹力图评价脑卒中患者抗血小板治疗的临床研究

摘要/Abstract

摘要： 目的：应用血栓弹力图评估阿司匹林联合氯吡格雷治疗缺血性脑血管病的抗血小板临床效果。方法：纳入120例缺血性脑梗死患者分为A、B、C 3组，每组40例。A组口服阿司匹林，B组口服氯吡格雷，C组口服阿司匹林联合氯吡格雷，用药21d后根据血栓弹力图结果选择敏感抗血小板药物单用，3组均连续服用3个月。观察治疗后各组间二磷酸腺苷（ADP）、花生四烯酸（AA）途径诱导的血小板抑制率，比较入院时NIHSS评分及以及治疗后3个月内主要不良事件的发生情况。检测3组血小板参数中血小板数（PLT）、平均血小板体积（MPV）的变化。结果：A组和B组AA途径诱导的抑制率有统计学差异(P<0.05)，A组和C组的AA途径诱导的抑制率无统计学差异(P>0.05)，B组和C组AA途径诱导的抑制率有显著差异(P<0.01)。A组和B组ADP途径诱导的抑制率有显著差异(P<0.01)，A组和C组ADP途径诱导的抑制率有显著差异(P<0.01)，B组和C组AA途径诱导的抑制率有显著差异(P<0.05)。3组间不良事件发生率差异无统计学意义。3组间PLT比较差异无统计学意义（P＞0.05），A组平均血小板体积（MPV）与B组、C组比较差异均有统计学意义（P<0.05），B组MPV与C组比较差异无统计学意义（P>0.05）。结论：急性非心源性缺血性脑血管病患者在急性期给予双抗血小板治疗，并根据血栓弹力图结果选择敏感药物可增加患者抗血小板受益，降低出血风险。

Abstract: Objective： To evaluate the clinical results of aspirin combined with clopidogrel for ischemic cerebrovascular disease according to thromboelastography(TEG).Methods： Included in the 120 cases of ischemic infarction were A， B， and C，40 in each group.A group of aspirin；Group B oral clopidogrel；Group C oral aspirin was combined with clopidogrel， and 21 d after the use of the platelet graph，the group was selected for the sensitive antiplatelet agent，and the 3 groups were taken for 3 months.Observation after treatment between groups of adenosine diphosphate (ADP)，arachidonic acid (AA) induced platelet inhibition rate，compare the NIHSS score on admission and major adverse events occurred within 3 months after treatment.The changes of platelet number (PLT) and average platelet volume (MPV) were detected in three groups of platelet parameters.Results：In group A and group B AA way induced inhibition rate was statistically difference (P<0.05)， group A and group C AA way induced the inhibition rate has no statistical difference (P>0.05)， group B and group C AA way induced inhibition rate has significant difference (P<0.01). Group A and group B inhibition induced by ADP ways has significant difference (P<0.01)， group A and group C inhibition induced by ADP ways had significant difference (P<0.01)， group B and group C AA way induced inhibition rate has significant difference (P<0.05).The incidence of adverse events in the three groups was not statistically significant. PLT comparing differences in three groups have no statistical significance (P>0.05)， mean platelet volume (MPV) in group A and group B，group C comparative differences are statistically significant (P<0.05). MPV group B there was no statistically significant difference compared with group C (P>0.05).Conclusion： Acute non cardiac ischemic cerebrovascular disease in the acute phase to dual antiplatelet therapy， and choose according to the results of the platelet figure sensitive antiplatelet drugs can increase the patients benefit and reduce the risk of bleeding.

黄坤,马效雷,李支援. 血栓弹力图评价脑卒中患者抗血小板治疗的临床研究[J]. .

HUANG Kun,MA XiaoLei and LI ZhiYuan. Clinical Study of Antiplatelet Therapy in Stroke Patients According to Thromboelastography[J]. .

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