对氯吡格雷低反应的STEMI患者应用替格瑞洛后ADP诱导的血小板抑制率的变化  

Change in platelet inhibition rate induced by ADP in STEMI patients with low response to clopidogrel after taking ticagrelor

作　　者：陈立伟[1] 韩凌[1] 骆景光[1] 高亢[1] 杨明[1] 

机构地区：[1]首都医科大学附属复兴医院心内科,北京100038

出　　处：《岭南心血管病杂志》2015年第2期149-151,175,共4页South China Journal of Cardiovascular Diseases

摘　　要：目的 探讨对氯吡格雷低反应的急性ST段抬高心肌梗死（ST segment elevation myocardial infarction,STEMI）患者应用替格瑞洛后腺苷二磷酸（adenosine diphosphate,ADP）诱导的血小板抑制率的变化。方法 连续入选2013年2月至2014年3月在复兴医院心脏中心住院,诊断为STEMI同时存在对氯吡格雷低反应性的18岁~80岁的患者共38例。将患者（在SAS软件下）随机分为替格瑞洛治疗组和常规治疗组。两组均于1周后复查ADP诱导的血小板抑制率。比较两组ADP诱导的血小板抑制率和ADP达标率。结果 与常规治疗组相比,替格瑞洛组ADP诱导的血小板抑制率明显升高,差异有统计学意义（78.32%±12.95%vs.31.89%±11.28%,t=11.779,P〈0.001]。替格瑞洛组较常规治疗组ADP达标率明显提高,差异有统计学意义[89.5%（12/19）vs.10.5%（2/19）,χ2=23.684,P〈0.001）。结论 对氯吡格雷低反应的STEMI患者应用替格瑞洛后ADP诱导的血小板抑制率明显升高。Objectives To investigate the change in platelet inhibition rate induced by adenosine diphosphate（ADP） in ST segment elevation myocardial infarction（STEMI） patients with low response to clopidogrel after taking ticagrelor.Methods We continuously selected 38 STEMI patients with low response to clopidogrel hydrogen sulfate aged from 18 to 80 years old in the Heart Center of Fuxing Hospital from February 2013 to March 2014. All the patients were randomly divided into ticagrelor treatment group and routine group. Platelet inhibition rate induced by ADP of the two groups were counterchecked in one week. Platelet inhibition rate induced by ADP and control rate of ADP between the two groups were compared. Results Compared with routine group,platelet inhibition rate induced by ADP in ticagrelor group increased significantly（78.32% ±12.95% vs. 31.89% ±11.28%, t =11.779, P〈0.001）. Control rate of ADP in ticagrelor group obviously improved [89.5%（12 / 19） vs. 10.5%（2 / 19）, χ2=23.684, P〈0.001]. Conclusions Platelet inhibition rate induced by ADP in STEMI patients with low response to clopidogrel significantly increases after taking ticagrelor.

关 键 词：心肌梗死 血小板聚集率 腺苷二磷酸 氯吡格雷低反应 

分 类 号：R542.22[医药卫生—心血管疾病]