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目的探讨经皮冠状动脉介入治疗(PCI)患者,术后利用血栓弹力图指导抗血小板药物的使用。方法分析我院近期4个月349例经皮冠状动脉介入治疗患者,根据是否做血栓弹力图(TEG)将其分为试验组和对照组。2组患者均使用阿司匹林+氯吡格雷的联合用药方案,再根据抗血小板药物剂量不同,2组又分别分为2个亚组,其中A组抗血小板药物为阿司匹林100 mg+氯吡格雷75 mg;B组抗血小板药物为阿司匹林300 mg+氯吡格雷75 mg。2组患者均予6个月随访,以确定不良缺血事件和出血事件的发生情况。结果试验组比对照组的不良缺血事件和出血事件的发生明显降低,试验组中B组比A组的花生四烯酸抑制率和二磷酸腺苷抑制率明显提高。结论根据血栓弹力图测定的血小板抑制率,调整经皮冠状动脉介入治疗患者的抗血小板药物使用,可减少不良事件的发生。
Objective To investigate percutaneous coronary intervention (PCI) in patients with postoperative use of thrombelastography to guide the use of antiplatelet drugs. Methods 349 patients with percutaneous coronary intervention in our hospital in the recent 4 months were divided into test group and control group according to whether thromboelastogram (TEG) or not. Patients in both groups were given aspirin + clopidogrel combination regimen. According to the dose of antiplatelet drugs, the two groups were divided into two subgroups. The antiplatelet agents in group A were aspirin 100 mg plus clopidogrel 75 mg. Group B antiplatelet drugs aspirin 300 mg + clopidogrel 75 mg. Both groups were followed up for 6 months to determine the occurrence of adverse ischemic and bleeding events. Results The incidence of adverse ischemic events and bleeding episodes in the experimental group was significantly lower than that in the control group. In the experimental group, the inhibition rates of arachidonic acid and adenosine diphosphate in group B were significantly higher than those in group A. Conclusion According to the platelet inhibition rate measured by thromboelastometry, adjusting the use of antiplatelet drugs in patients undergoing percutaneous coronary intervention can reduce the incidence of adverse events.