血小板聚集率检测对行经皮冠脉介入术患者的临床意义探讨

目的研究血小板聚集率检测水平与行经皮冠脉介入（percutancous coronary intervention,PCI）术后患者心血管不良事件的相关性。方法用比浊法和阻抗法检测119例行PCI术服用阿司匹林和氯吡格雷超过7 d的患者的血浆或全血的血小板聚集率,促凝剂分别为终浓度为5μmo/lL的ADP或终浓度为2 mg/L的胶原。1年后随访,用SPSS13.0对未发生心血管不良事件及发生心血管不良事件组的患者的血小板聚集率平均值进行统计学分析。结果 13例发生心肌缺血等心血管不良事件组患者以ADP为促凝剂比浊法测定的血小板聚集率平均值（0.63±0.12）,与未发生心血管不良事件组患者的血小板聚集率平均值（0.48±0.18）比较,差异有统计学意义（P〈0.05）;两组患者以胶原为促凝剂阻抗法检测的血小板聚集率平均值（分别为8.3±3.8和5.2±3.3）比较,差异有统计学意义。两组患者以ADP为促凝剂阻抗法测定的血小板聚集率平均值,及以胶原为促凝剂比浊法检测的血小板聚集率平均值比较差异无统计学意义。结论以ADP为促凝剂比浊法,及以胶原为促凝剂阻抗法检测的血小板聚集率,与行PCI术常规服用阿司匹林和氯吡格雷抗血小板药的患者是否易发生心血管不良事件,有一定的相关性。

Clinical Significance of Detection of Platelet Aggregation Ratio in Patients Undergoing Percutancous Coronary Intervention

Objective To explore the correlation between platelet aggregation rate and adverse cardiovascular events in patients undergoing percutancous coronary intervention(PCI) intervention.Methods Plasma or whole blood platelet aggregation rate was assayed by use of optical and impedance platelet aggregometry with 5 μmol ADP and 2 mg/L collagen in 119 patients who underwent PCI and received aspirin and clopidogrel over 7 days.Follow-up visit was done one year later,and statistical significance of the mean platelet aggregation between adverse cardiovascular event group and stable group was calculated by use of SPSS 13.0 software package.Results There were statistically significant differences in the mean platelet aggregation between 13 patients(0.63±0.12) suffered from adverse cardiovascular events detected by optical platelet aggregometry with ADP and stable patients(0.48±0.18),(P<0.05).There were statistically significant differences in the mean platelet aggregation detected by collagen platelet aggregometry between the two groups(8.3±3.8 and 5.2±3.3,respectively).No statistically significant difference was found in the mean platelet aggregation detected by impedance aggregometry with ADP or by optical platelet aggregometry with collagen between the two groups.Conclusions The platelet aggregation by optical aggregometry with ADP or by impedance aggegometry with collagen may help to identify adverse cardiovascular events on patients undergoing PCI.