[1]芦璐,房淑欣,高阳.血栓弹力图评价阿司匹林与氯吡格雷对急性脑梗死病人抗血小板效果[J].齐鲁医学杂志,2017,32(06):707-710.[doi:10.13362/j.qlyx.201706022]
 LU Lu,FANG Shuxin,GAO Yang.ANTIPLATELET EFFECT OF ASPIRIN AND CLOPIDOGREL IN PATIENTS WITH ACUTE CEREBRAL INFARCTION AS EVALUATED USING THROMBOELASTOGRAPHY[J].Medical Journal of Qilu,2017,32(06):707-710.[doi:10.13362/j.qlyx.201706022]
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血栓弹力图评价阿司匹林与氯吡格雷对急性脑梗死病人抗血小板效果()
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《齐鲁医学杂志》[ISSN:1008-0341/CN:37-1280/R]

卷:
第32卷
期数:
2017年06期
页码:
707-710
栏目:
出版日期:
2018-03-20

文章信息/Info

Title:
ANTIPLATELET EFFECT OF ASPIRIN AND CLOPIDOGREL IN PATIENTS WITH ACUTE CEREBRAL INFARCTION AS EVALUATED USING THROMBOELASTOGRAPHY
文章编号:
1008-0341(2017)06-0707-04
作者:
芦璐房淑欣高阳
山东省立第三医院(山东省血栓病防治工程技术研究中心)血栓科,山东 济南 250031
Author(s):
LU Lu FANG Shuxin GAO Yang
Shandong Rearch Center for Thrombotic Disease, Shandong Traffic Hosptial, Ji′nan 250031, China
关键词:
脑梗死血栓弹力描记术阿司匹林氯吡格雷血小板抑制率炎症趋化因子类
Keywords:
cerebral infarction thrombelastogra aspirin cloidogrel platelet inhibition rate chemokines
分类号:
R743.33
DOI:
10.13362/j.qlyx.201706022
文献标志码:
A
摘要:
目的 探讨血栓弹力图(TEG)评价急性脑梗死病人应用阿司匹林及氯吡格雷抗血小板的治疗效果,为临床抗血小板药物个体化治疗提供依据。
方法 将300例急性脑梗死病人分为阿司匹林组、氯吡格雷组以及联合用药组,每组100例。治疗前、治疗后2周应用TEG测定花生四烯酸(AA)及二磷酸腺苷(ADP)途径诱导的血小板抑制率,采用免疫比浊法测定3组病人血清超敏C反应蛋白(hs-CRP)水平。
结果 3组病人治疗后血小板抑制率均高于治疗前,差异有统计学意义(t=2.141~2.791,P<0.05)。联合用药组治疗后AA及ADP途径诱导的血小板抑制率与单一用药组比较,差异有显著性(F=12.413、13.586,P<0.05)。3组病人治疗后血清hs-CRP水平较治疗前明显降低(t=6.682~8.417,P<0.05),联合用药组治疗后血清hs-CRP水平较单一用药组明显降低,差异有显著性(F=7.025、9.412,P<0.05)。3组病人均未发生致死性出血现象。
结论 阿司匹林及氯吡格雷均具有抗血小板作用,两药联合应用可从两个途径有效抑制血小板聚集,起到更强的抗血小板作用,可降低血小板聚集活性,减少血管炎性反应,减少血栓发生风险。
Abstract:
Objective  To investigate the antiplatelet effect of aspirin and clopidogrel in patients with acute cerebral infarction using thromboelastography (TEG), and to provide a basis for individualized treatment with antiplatelet drugs in clinical practice.
Methods  A total of 300 patients with acute cerebral infarction were divided into aspirin group, clopidogrel group, and combination group, with 100 patients in each group. TEG was used to measure platelet inhibition rate induced by the arachidonic acid (AA) and adenosine diphosphate (ADP) pathways before treatment and at 2 weeks after treatment, and immunoturbidimetry was used to measure the serum level of high-sensitivity C-reactive protein (hs-CRP).
Results  All three groups had a significant increase in platelet inhibition rate after treatment (t=2.141-2.791,P<0.05). After treatment, there was a significant difference in platelet inhibition rate induced by the AA and ADP pathways between the combination group and the aspirin/clopidogrel groups (F=12.413 and 13.586,P<0.05). All three groups had a significant reduction in the serum level of hs-CRP after treatment (t=6.682-8.417,P<0.05), and after treatment, the combination group had a significantly lower serum level of hs-CRP than the aspirin group and the clopidogrel groups (F=7.025 and 9.412,P<0.05). No patient experienced fatal bleeding.
Conclusion  Both aspirin and clopidogrel have an antiplatelet effect, and a combination of these two drugs can effectively inhibit platelet aggregation via two pathways and thus exerts a stronger antiplatelet effect than aspirin or clopidogrel alone. It can reduce platelet aggregation, vascular inflammatory response, and the risk of thrombosis.
更新日期/Last Update: 2018-03-24