血栓弹力图和CYP2C19基因分型在指导左主干支架植入术后应用抗血小板药物的治疗探讨

目的探讨根据联合检测血栓弹力图和CYP2C19基因分型的结果优化冠状动脉左主干支架植入术后应用抗血小板药物治疗的临床效果。方法98例左主干支架术植入术后患，联合检测血栓弹力图和CYP2C19基因分型，根据结果分为3组，合格组、常规剂量治疗组、大剂量治疗组，随访6个月记录患者的主要心脏不良事件（MACE）发生情况。结果随访6个月共发生主要心脏不良事件13例，其中合格组6例（11．7％），常规治疗组4例（16．0％），大剂量治疗组3例（13．6％），3组中常规剂量治疗组的不良事件发生率大于大剂量治疗组，大剂量治疗组大于合格组，差异有统计学意义（P〈0．05）。结论联合检测弹力图和CYP2C19基因分型在优化左主干支架植入术后应用抗血小板药物治疗具有一定的指导意义。

The Application of Joint Detection Thrombelastograph and CYP2 C19 Gen-otype in Guiding Left Main Application of Antiplatelet Therapy after Stent Implantation

OBJECTIVE To investigate the clinical effect of antiplatelet therapy according to the joint detection thrombelastograph and CYP2C19 genotype results after left main coronary artery stent implantation. METHODS 98 patients were divided into three groups：qualified group, conventional dose treatment group, high-dose treatment group after left main artery stent implantation, according to the result of joint detection thrombelastograph and CYP2C19 genotype. The major adverse cardiac events （MACE） of patients after followed up for 6 months. RESULTS A total of 13 cases of major adverse cardiac events,including qualified group of 6 cases （ II. 7% ） ,4 cases （ 16.0% ） and conventional treatment group high-dose treatment group 3 cases （ 13.6% ） After followed up for 6 months. The inci- dence of adverse events than high-dose treatment group, high-dose treatment group is more than qualified group, the difference was statistically significant （P 〈 0. 05 ）. CONCLUSION Joint detection thrombelastograph and CYP2C19 genotype has a certain guiding significance in the optimization of antiplatelet therapy after left main artery stent implantation.