冠状动脉支架术患者停用氯吡格雷后血小板功能的变化  

Changes of platelet function after clopidogrel discontinuation in patients with percutaneous coronary interventions

作　　者：杨帆[1,2] 谭保平[1,2] 何柳平[1,2] 王红[1,2] 吴昊[1,2] 

机构地区：[1]广西医科大学第四附属医院 [2]柳州市工人医院心内科,广西柳州545005

出　　处：《重庆医学》2014年第12期1436-1438,共3页Chongqing medicine

基　　金：广西壮族自治区科技厅资助项目(桂科攻10124001B-17);柳州市科技厅科研资助项目(2010030726)

摘　　要：目的观察经皮冠状动脉介入治疗(PCI)术患者氯吡格雷停用后血小板聚集率及血小板CD41+CD62P+表达的变化。方法对52例已服用氯吡格雷12个月但即将停药的PCI患者,比较氯吡格雷治疗前(T0)、治疗后1周(T1),停药前1周(T2)、停药后1周(T3)及停药后1个月(T4)血小板聚集率和血小板CD41+CD62P+阳性率。结果与T0比较,T1血小板聚集率及CD41+CD62P+表达均显著下降,差异有统计学意义(P<0.05);T2仍维持较低水平;T3血小板聚集率及CD41+CD62P+表达升高,T4血小板聚集率及CD41+CD62P+恢复至T0水平,T0、T1、T2、T3、T4各时间点血小板聚集率分别为(44.20±18.36)%、(25.38±12.10)%、(23.74±8.15)%、(51.79±10.55)%、(45.97±16.42)%,血小板CD41+CD62P+阳性率分别为(12.96±11.48)%、(3.93±3.33)%、(4.72±3.14)%、(13.90±10.38)%、(10.84±8.13)%。结论 PCI术后已服用氯吡格雷12个月者,停用氯吡格雷后1周时血小板聚集率、血小板CD41+CD62P+阳性率轻度增加,在停药后1个月时逐渐恢复至停药前水平。Objective To investigate the changes of platelet aggregation rate and platelet surface CD 41＋CD62P＋ expression af-ter clopidogrel discontinuation in the patients with percutaneous coronary interventions （PCI）） .Methods The platelet aggregation rates and platelet surface CD41＋CD62P＋ in 52 PCI patients with oral clopidogrel for near 12 months and discontinuation soon were measured before clopidogrel therapy（T0 ） ,in 1 week after clopidogrel therapy（T1 ） ,1 week before clopidogrel discontinuation（T2 ） , 1 week（T3 ） and 1 month after clopidogrel discontinuation （T4 ） .Results Compared with T0 ,the platelet aggregation rate and the expression of platelet CD41＋CD62P＋ at T1 were significantly decreased ,the difference showing statistical significance （P＆lt;0 .05） , which at T2 maintained the lower levels ;which at T3 were increased ,which at T4 were recovered to those at T0 .The platelet aggre-gation rates at various time points were （44 .20 ± 18 .36）% ,（25 .38 ± 12 .10）% ,（23 .74 ± 8 .15）% ,（51 .79 ± 10 .55）% and（45 .97 ± 16 .42）% respectively ,and the positive rates of CD41＋ CD62P＋ were（12 .96 ± 11 .48）% ,（3 .93 ± 3 .33）% ,（4 .72 ± 3 .14）% , （13 .90 ± 10 .38）% and（10 .84 ± 8 .13）% ,respectively .Conclusion In the patients treated with 12-month clopidogrel after PCI ,the platelet aggregation rate and the CD41＋CD62P＋ positive rate are mildly increased at 1 week after clopidogrel discontinuation and gradually returned to the level before discontinuation at 1 month after clopidogrel discontinuation .

关 键 词：经皮冠状动脉介入治疗 血小板聚集 CD41+CD62P+ 氯吡格雷 

分 类 号：R541.4[医药卫生—心血管疾病]