血栓弹力图在不稳定心绞痛患者病情评估及PCI术后抗血小板治疗中的临床价值

【目的】探讨血栓弹力图(TEG)在不稳定心绞痛(UAP)患者病情评估及PCI术后抗血小板治疗中的临床价值。【方法】选取本院收治的117例UAP患者,根据冠脉病变支数将其分为单支病变、双支病变及三支病变组,对比各组的TEG参数;并根据UAP患者PCI后抗血小板治疗方法的不同分为氣吡格雷组和替格瑞洛组,分析两组的血小板抑制率、TEG参数差异。【结果】三支病变、双支病变组UAP患者反应时间(R)均显著地低于单支病变组,三支病变组UAP患者R值均显著地低于双支病变组;三支病变、双支病变组UAP患者a角、最大振幅(MA)值均显著地高于单支病变组,三支病变组UAP患者α角、MA值均显著地高于双支病变组(P<0.05)。PCI术后,替格瑞洛组患者R值高于氣吡格雷组,α角、MA值则均低于氯吡格雷组患者,差异均有统计学意义(P<0.05)。PCI术后,替格瑞洛组患者AA途径、ADP途径血小板抑制率均高于氣吡格雷组,差异有统计学意义(P<0.05)。【结论】TEG检测对于评估UAP患者冠脉病变程度、PCI术后抗血小板治疗效果具有一定的临床价值。

Clinical Value of Thromboelastography(TEG)in the Evaluation of Patients with Unstable Angina and Antiplatelet Therapy after PCI

【Objective】To explore the clinical value of throm boelastography(TEG)in the evaluation of patients with unstable angina pectoris(UAP)and antiplatelet therapy after PCI.【Methods】One hundred and seventeen UAP patients in our hospital were divided into single vessel disease,double vessel disease and three vessel disease groups according to the num ber of coronary lesions.TEG param eters of each group were com pared.According to the different antiplatelet treatment methods of UAP patients after PCI,they were divided into clopidogrel group and tegrerolol group.The platelet inhibition rate and T EG param eters of the two groups were analyzed.【Results】The response time(R)of UAP patients in the three vessel disease group and the two vessel disease group was significantly lower than that the in single vessel the disease group,and the R value of UAP patients in the three vessel disease group was significantly lower than that in the two vessel disease gro u p;the a angle and Ma value of UAP patients in the three vessel disease group and the two vessel disease group were significantly higher than that in the single vessel disease group,and the a angle and Ma value of UAP patients in the three vessel disease group were significantly higher than that in the two vessel disease group(P<0.05).After PCI,the R value of the tegrilol group was higher than that of the clopidogrel group,while the a angle and MA value were lower than those of the clopidogrel group(P<0.05).A fter PCI,the platelet inhibition rate of AA pathw ay and ADP pathway in the tegrilol group was higher than that in the clopidogrel group(P<0.05).【Conclusion】TEG detection has a certain clinical value in evaluating the degree of coronary lesions in UAP patients and the effect of antiplatelet therapy after PCI.