中国全科医学2017，Vol.20Issue(33)：4125-4129,5.DOI:10.3969/j.issn.1007-9572.2017.00.130
介入治疗对冠心病患者血小板活化指标和抗血小板治疗效果及预后的影响研究
Impact of Interventional Therapy on Platelet Activation Indices, Efficacy of Antiplatelet Therapy and Prognosis in Patients with Coronary Heart Disease
摘要
Abstract
Objective To examine the impact of interventional therapy on platelet activation indices,efficacy of antiplatelet therapy and prognosis in patients with coronary heart disease (CHD).Methods A total of 270 patients with CHD who were admitted to the Department of Cardiology of the Affiliated Hospital of North China University of Science and Technology from July 2014 to June 2015 were enrolled in this study.All subjects were assigned to one of two groups according to disease condition,results of coronary angiogram and individual preference.Patients in the non-interventional group (n =124) were given drug therapy alone,while subjects in the interventional group (n =146) received drug therapy plus stent implantation.General characteristics were collected for all patients,and blood biochemical parameters,platelet activation indices and high-sensitivity C-reaction protein (hs-CRP) were measured and compared between the two groups.The efficacy of antiplatelet therapy was evaluated and the incidence of major adverse cardiovascular events (MACE) and rehospitalization rates were recorded.Results Levels of 6-keto-prostaglandin F1a (PGF) were lower in the interventional group than in the non-interventional group and P-selectin (PS),the maximum platelet aggregation rate (MPAR) induced by arachidonic acid (AA),dTP and hs-CRP were higher in the interventional group than in the non-interventional group (P ＜ 0.05).Antiplatelet therapy was found to be less effective in the interventional group compared with the non-interventional group (P ＜ 0.05),although there were no significant differences in the incidence of MACE [28.2％ (35/124) in the non-interventional group and 32.2％ (47 /146) in the interventional group,P ＞ 0.05] or rehospitalization rates [12.1％ (15/124) in the non-interventional group and 18.5％ (27/146) in the interventional group,P ＞ 0.05] between the two groups.Conclusion Interventional therapy may promote platelet activation and inflammatory reactions,leading to resistance to antiplatelet drugs,although it does not increase the incidence of MACE or rehospitalization rates.It is suggested that antiplatelet therapy should be increased in CHD patients.undergoing interventional therapy.关键词
冠心病/血小板活化/随访研究/放射摄影术,介入性Key words
Coronary disease/Platelet activation/Follow-up studies/Radiography, interventional分类
医药卫生引用本文复制引用
王志军,王硕,王泽宇,周建芝,方晓明,李素新,黄宇玲,李海涛..介入治疗对冠心病患者血小板活化指标和抗血小板治疗效果及预后的影响研究[J].中国全科医学,2017,20(33):4125-4129,5.基金项目
河北省卫生厅医学研究重点课题计划项目(20100474) （20100474）
