双联抗血小板治疗对药物洗脱支架术后患者血液流变学的影响  

Impact of dual antiplatelet therapy on blood viscosity after treatment with drug-eluting coronary stents

作　　者：阚静[1,2] 陈绍良[1] 林玲[1] 徐海梅[1] 赵莹莹[1] 刘彦[1] 陈峰[2] 

机构地区：[1]南京医科大学附属南京医院,江苏南京210006 [2]南京医科大学公共卫生学院,江苏南京210006

出　　处：《国际检验医学杂志》2013年第6期653-655,共3页International Journal of Laboratory Medicine

摘　　要：目的探讨双联抗血小板治疗对药物洗脱支架术后不同性别患者血液流变学的影响。方法选择2009年9月至2009年12月接受药物洗脱支架置入术的598例冠心病患者,排除急性心肌梗死、急性脑梗死、肿瘤、肺源性心脏病、血流变学检查异常者,共有444例患者纳入分析。其中214例在术后9个月完成血液流变学检测随访。用ZL9000PLUS型血流变测定仪测定全血黏度(高切、中切、低切)、血浆黏度、血细胞比容、红细胞变形指数、红细胞聚集指数、红细胞电泳时间。结果药物洗脱支架术后双联抗血小板治疗9个月时,患者的全血黏度均明显升高,但全血低切还原黏度轻度降低,男性组红细胞沉降率和红细胞沉降率方程K值(除去血细胞比容的影响后的红细胞沉降率校正值)明显减小,但女性组变化不明显。结论双联抗血小板治疗可以降低男性红细胞聚集,从而减少男性冠心病患者药物洗脱支架术后主要不良心脏事件的发生。Objective To study the effect of dual antiplatelet therapy on blood viscosity in women and men after drug-eluting stent implantation. Methods 598 consecutive patients with coronary artery disease were treated by drug-eluting stent implantation from May 2009 to December 2010 ,of which 444 patients were included in the analysis, excluded acute myocardial infarction, acute cerebral infarction, tumor, cor pulmonale, and abnormal hemorrheology. 214 among them completed with hemorrheology follow-up 9 months after the teatment. The hemorheology was measured with hemorrheology tester （ZL9000 PLUS）, including whole blood viscosity （high cut, cut,low cut）, plasma viscosity, red blood cell deposited, erythrocyte deformation index, red cell aggregation index, and red blood cells electrophoretic time. Results Whole blood viscosity were significantly increased in patients with dual antiplatelet therapy continue 9-months after drug-eluting stent implantation. However, the low shear whole blood reductive viscosity were slightly reduce. The erythrocyte sedimentation rate （ESR） and Equation K value of ESR （correction value of ESR divided hematocrit） significantly slower in men,which were not observed in women. Conclusion The decrease of red cell aggregation in men with dual antiplatelet therapy after drug-eluting stent implantation would be reduce major adverse cardiac events.

关 键 词：血液黏度 冠心病 血小板聚集抑制剂 药物洗脱支架 

分 类 号：R541.4[医药卫生—心血管疾病]