冠脉介入术后气虚血瘀证对抗栓疗效的影响

目的:探讨经皮冠状动脉介入(PCI)术后气虚血瘀证对抗栓疗效的影响。方法:123例行PCI成功的冠心病患者进行术后规范抗栓治疗,根据术后1周是否有气虚血瘀证表型分为气虚血瘀组(49例)和非气虚血瘀组(74例),同时采血检测血小板计数(PLT)、最大血小板聚集率(MPA)、血浆遗传性假血友病因子(vWF)、血小板膜糖蛋白Ⅱb/Ⅲa(GPⅡb/Ⅲa)、凝血酶原片段1+2(F1+2)和纤维蛋白原(Fg)。结果:PCI术后气虚血瘀组MPA、vWF、GPⅡb/Ⅲa高于非气虚血瘀组(P<0.05),而PLT、F(1+2)和Fg两组间差异无统计学意义(P>0.05)。结论:在PCI术后强化抗栓治疗的基础上,气虚血瘀证仍然存在明显的血小板活化和血管内皮损伤,但不影响血小板数量和凝血功能。

Effects of Qi Deficiency and Blood Stasis Syndrome after Percutaneous Coronary Intervention on Antithrombotic Therapy

Objective：To analyze the effects of qi deficiency and blood stasis syndrome after Percutaneous Coronary Interven- tion （PCI） on antithrombotic therapy. Methods ： We adopted 123 CHD patients after receiving successful PCI. After 7 days of standard antithrombotic therapy, Traditional Chinese Medicine （TCM） syndromes were differentiated into qi - deficiency blood - stasis type and non- qi -deficiency blood- stasis type. All patients were detected platelet count （PLT） ,maximum platelet aggregation rate （ MPA ）, plasma yon Willebrand factor （ vWF ）, platelet membrane glycoproteins Ⅱ b/Ⅲa （ GP Ⅱ b/Ⅲ a ）, prothrombin frag- mentl ＋ 2 （ F1 ＋ 2 ） and fibrinogen （Fg）. Results ： Compared with the non - qi - deficiency blood - stasis group after PCI, the MPA, vWF and GP II b/III a were obviously higher in qi - deficiency blood - stasis group （ P 〈 0.05 ）, and there was no statistical difference of PLT, F （1 ＋ 2 ） and Fg between the two groups （P 〉 O. 05 ）. Conclusion：Qi deficiency and blood stasis syndrome after PCI affected platelete activation and ndothelial function on standard antithrombotic therapy, whereas the number of blood platelet and coagulation function were not.