对氯吡格雷低反应的STEMI患者应用替格瑞洛后ADP诱导的血小板抑制率的变化.pdf

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1、岭南心血管病杂志2015年3月第21卷第2期·149·doi10．3969，i．issn．1007—9688．2015．02．OO4·论著·对氯吡格雷低反应的STEMI患者应用替格瑞洛后ADP诱导的血小板抑制率的变化陈立伟，韩凌，骆景光，高亢，杨明(首都医科大学附属复兴医院心内科，北京100038)摘要：目的探讨对氯吡格雷低反应的急性sT段抬高心肌梗死(STsegmentelevationmyocardialinfarction，STEMI)患者应用替格瑞洛后腺苷二磷酸(adenosinediphosphate，ADP)诱导的血小板抑制率的变化。方法连续入选2013年2

2、月至2014年3月在复兴医院心脏中心住院，诊断为STEMI同时存在对氯吡格雷低反应性的18岁8O岁的患者共38例。将患者(在SAS软件下)随机分为替格瑞洛治疗组和常规治疗组。两组均于1周后复查ADP诱导的血小板抑制率。比较两组ADP诱导的血小板抑制率和ADP达标率。结果与常规治疗组相比，替格瑞洛组ADP诱导的血小板抑制率明显升高，差异有统计学意义(78．32％~12．95％眠31．89％+11．28％，t=l1．779，P<0．001]。替格瑞洛组较常规治疗组ADP达标率明显提高，差异有统计学意义[89．5％(12／19)10．5％(2／19)=23．684，P<0．0

3、01)。结论对氯吡格雷低反应的STEMI患者应用替格瑞洛后ADP诱导的血小板抑制率明显升高。关键词：心肌梗死；血小板聚集率；腺苷二磷酸；氯吡格雷低反应中图分类号：R542．22文献标志码：A文章编号：1007—9688(2015)02—0149—03ChangeinplateletinhibitionrateinducedbyADPinSTEMIpatientswithlowresponsetoclopidogrelaftertakingticagrelorCHENLi—wei，HANLing，LUOJing—guang，GAOKang，YANGMing(Departm

4、entofCardiology，FuxingHospitalAfiliatedtoCapitalMedicalUniversity，Beijing100038，China)Abstract：ObjectivesToinvestigatethechangeinplateletinhibitionrateinducedbyadenosinediphosphate(ADP)inSTsegmentelevationmyocardialinfarction(STEMI)patientswithlowresponsetoclopidogrelaftertakingfieagrelo

5、r．MethodsWecontinuouslyselected38STEMIpatientswithlowresponsetoelopidogrelhydrogensulfateagedfrom18to80yearsoldintheHeartCenterofFuxingHospitalfromFebruary2013toMarch2014．Allthepatientswererandomlydividedintoticagrelortreatmentgroupandroutinegroup．PlateletinhibitionrateinducedbyADPofthet

6、wogroupswerecountercheckedinoneweek．PlateletinhibitionrateinducedbyADPandcontrolrateofADPbetweenthetwogroupswerecompared．ResultsComparedwithroutinegroup，plateletinhibitionrateinducedbyADPintieagrelorgroupincreasedsignificantly(78．32％~12．95％VS．31．89％±l1．28％，t=l1．779，P<0．001)．Controlrateof

7、ADPinticagrelorgroupobviouslyimproved[89．5％(12／19)VS．10．5％(2／19)，=23．684，P<0．001]．ConclusionsPlateletinhibitionrateinducedbyADPinSTEMIpatientswithlowresponsetoclopidogrelsignificantlyincreasesaftertakingtieagrelor．Keywords：myocardialinfarction；plateletaggregationrate；aden