血栓弹力图指导抗血小板治疗对缺血性脑卒中二级预防效果影响的研究

目的 分析血栓弹力图(TEG)指导抗血小板治疗在急性缺血性脑卒中(CIS)二级预防中的应用效果.方法 86例CIS患者,随机分为TEG组与常规组,每组43例.常规组接受常规抗血小板治疗,TEG组接受TEG指导下抗血小板治疗.比较两组抗血小板药物抵抗发生率、血小板计数(PLT)、花生四烯酸诱导的血小板抑制率(AA％)及二...

Study on the effect of thromboelastography-guided antiplatelet therapy on the secondary prevention of cerebral ischemic stroke

Objective To analyze the practical effect of thromboelastography(TEG)-guided antiplatelet therapy on the secondary prevention of cerebral ischemic stroke(CIS).Methods A total of 86 CIS patients were randomly divided into TEG group and conventional group,with 43 cases in each group.The conventional group received conventional antiplatelet therapy,and the TEG group received antiplatelet therapy under the guidance of TEG.The incidence of antiplatelet drug resistance,platelet count(PLT),arachidonic acid-induced platelet inhibition rate(AA%),and adenosine diphosphate-induced platelet inhibition rate(ADP%)level changes were compared between the two groups,and the correlation between CYP2 C19 genotype and ADP%level was analyzed.Results 7 d after treatment,there was no statistically significant difference in incidence of aspirin resistance and clopidogrel resistance between the two groups(P>0.05).Before treatment,7 d and 14 d after treatment,the PLT level of the two groups showed a downward trend,and the difference was statistically significant(P<0.05).The level of AA%in the conventional group showed a downward trend,while the level of AA%in the TEG group decreased first and then increased,the difference was statistically significant(P<0.05).The level of ADP%in the conventional group showed a downward trend,while the level of ADP%in the TEG group decreased first and then increased,the difference was statistically significant(P<0.05).14 d after treatment,the PLT level(228.28±17.16)×10^9/L of TEG group was lower than(237.31±18.52)×10^9/L of the conventional group,and the difference was statistically significant(P<0.05).The AA%level of TEG group was higher than that of conventional group,and the difference was statistically significant(P<0.05).The ADP%level of TEG group was higher than that of conventional group,and the difference was statistically significant(P<0.05).Pearson correlation analysis showed that the degree of metabolism of CYP2 C19 genotype was positively correlated with the level of ADP%(r=0.692,P<0.05).Conclusion The application of antiplatelet drugs under the guidance of TEG in CIS secondary prevention can effectively improve platelet drug resistance and improve the effect of antiplatelet therapy.