冠状动脉介入治疗后应用氯吡格雷治疗的患者血小板活化情况

目的探讨冠状动脉介入治疗(PCI)后,患者应用氯吡格雷作为抗血小板药物口服治疗,观察血小板活化的变化情况。方法采用流式细胞术(FCM)分别对PCI患者和健康体检人群血小板GPⅡb/Ⅲa进行检测,同时观察PCI患者应用氯吡格雷治疗前、后血小板GPⅡb/Ⅲa水平的变化。结果实验组入选时与健康对照组进行比较,实验组入选时GPⅡb/Ⅲa的水平较健康对照组明显升高,两组血小板GPⅡb/Ⅲa水平差异有统计学意义(P<0.05)。用药7d后其GPⅡb/Ⅲa水平较入选时明显下降,两组血小板GPⅡb/Ⅲa水平差异有统计学意义(P<0.05)。而健康对照组与实验组用药7d后进行比较,两组血小板GPⅡb/Ⅲa水平差异无统计学意义(P>0.05)。结论 PCI后应用氯吡格雷治疗患者血小板活化水平大部分都有明显下降,但仍有少部分患者没有明显下降,推测可能与血小板抵抗有关。

Study of platelet activation in patients with clopidogrel therapy after coronary intervention

Objective To observe the platelet activation changes in patients with clopidogrel therapy after per- cutaneous coronary intervention （PCI）. Methods Platelet GP II b/III a level was analyzed in patients before and after undergoing PCI with clopidogrel therapy and healthy controls by using flow cytometry. Results The GP II b/III a lev- el was dramatically promoted in experiment group before clopidogrel therapy than that in control group （P〈0.05）, but there was no statistical difference after 7 days after clopidogrel therapy （P〉0. 05）. Conclusion After receiving PCI, the platelet activation level might be significantly higher than that in healthy subjects（P〈0.05）. Therapy of clopidogrel could reducing the platelet activation level in patients receiving PCI, but there were still 10.71% of pa- tients without significant decreasing （P〉0.05）, which might be related with platelet resistance.