氯吡格雷低反应性与支架内血栓形成的关系

被引：6

作者：

朱甜甜

李春坚

张秋

孔德玉

刘洁

陈波

贾恩志

陈磊磊

贾庆哲

陶正贤

张定国

戴振华

杨志健

曹克将

黄峻

机构：

[1] 南京医科大学第一附属医院心脏病科

来源：

江苏医药 | 2012年 / 38卷 / 12期

关键词：

氯吡格雷; 支架内血栓; 血小板聚集率; 冠心病;

D O I：

10.19460/j.cnki.0253-3685.2012.12.013

中图分类号：

R541.4 [冠状动脉（粥样）硬化性心脏病（冠心病）];

学科分类号：

摘要：

目的探讨氯吡格雷低反应性与冠状动脉支架内血栓的关系,评估氯吡格雷剂量加倍后的疗效。方法连续入选9例经冠状动脉造影确诊的支架内血栓患者为观察组,连续入选100例接受支架植入治疗的冠心病患者为对照组。用光学血小板聚集仪检测花生四烯酸(AA)和二磷酸腺苷(ADP)诱导的血小板聚集率(PLAA和PLADP)。将PLAA>20%、PLADP>40%分别定义为阿司匹林和氯吡格雷低反应性,对观察组氯吡格雷低反应者加倍剂量至150mg/d,随访PLADP及临床事件。结果观察组氯吡格雷低反应的发生率高于对照组(100%vs.27%)(P<0.01);观察组PLADP水平显著高于对照组[(53.6±6.3)%vs.(31.9±14.0)%](P<0.01);观察组氯吡格雷剂量加倍后,血小板聚集率显著降低[(53.6±6.3)%vs.(37.0±10.9)%](P<0.01)。观察组与对照组均未检出阿司匹林低反应患者。结论氯吡格雷低反应性是冠状动脉支架内血栓形成的危险因素。氯吡格雷剂量加倍可显著降低残余血小板聚集率,可能减少支架内血栓形成事件的发生。

引用

页码：1401 / 1403+1364 +1364

页数：4

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