经皮冠状动脉介入治疗患者氯吡格雷抵抗与CD62p表达及冠心病危险因素相关分析  

Analyze of the clopidogrel resistance, the relativity of CD62p and the dangerous factor of coronary after PCI

作　　者：金卫东[1] 刘艳宾[1] 王鹏飞[1] 王成[1] 刘振[1] 刘玲玲[1] 

机构地区：[1]河南省新乡市中心医院心内一科,453000

出　　处：《中国实用医刊》2011年第4期45-47,共3页Chinese Journal of Practical Medicine

摘　　要：目的 观察在经皮冠状动脉介入治疗（PCI）患者中硫酸氢氯吡格雷抵抗发生的情况，评价冠心病危险因素与氯吡格雷抵抗发生率的相关性，并进一步探讨氯吡格雷抵抗与CD62p的关联性。方法43例接受PCI治疗的患者在服用氯吡格雷前及服药后1个月抽血，利用比浊法测定ADP诱导的血小板最大聚集率（PAGM），同时用流式细胞术测定CD62p。根据PAGM降低程度判断氯吡格雷抵抗发生率。采集患者的冠心病危险因素资料，对各项因素与氯吡格雷抵抗发生率进行相关分析。结果43例给予氯吡格雷300mg负荷剂量进行PCI患者发生氯吡格雷抵抗者为11例（25．4％）；研究中发现糖尿病、甘油三酯增加氯吡格雷抵抗，而吸烟可能降低氯吡格雷抵抗，其他临床指标与氯吡格雷抵抗发生率无相关性；CD62p与PAGM具有正相关。结论PCI介入治疗的患者中存在部分氯吡格雷抵抗者；CD62p与PAGM百分比相比更具有意义，氯吡格雷抵抗可用CD62p的下降程度来界定。Objective To determine the relationship between risk factors of C HD and clopidogrel resistance, and CD62p expression after PCI. Methods Forty - three patients who underwent PCI were drawn blood before taking clopidogrel and taking the drug one month later respectively. ADP -induced platelet aggregation was measured by the measurement of resistvity and CD62p was determined by flow cytometry. The incidence of clopidogrel resistance was evaluated by the precent reduction of PAGM. Correlation analysis was made between the risk factors of CHD and the incidence of clopidogrel resistance. Results Of 43 patients pretreated with 300 mg of clopidogrel 〉 12 h prior to PCI and 75 mg the day of the PCI, 11 cases （25.4%） occurred clopidogrel resistance. Diabetes and TG increased clopidogrel resistance incidence, and cigarette smoking lowered the incidence. However, other risk factors studied in this research had no significant correlation with the incidence of elopidogrel resistance. A positive correlation was found between PAGM and CD62p. Conclusions Clopidogrel resistance occurs in some of the patients undergoing PCI. CD62p has a significant positive correlation with PAGM （more significant by percent ratio）. Clopidogrel resistance can be determined by the percent reduction of CD62p.

关 键 词：经皮冠状动脉介入治疗 氯吡格雷抵抗 血小板最大聚集率 CD62P 

分 类 号：R541.4[医药卫生—心血管疾病]