氯吡格雷反应性与神经介入手术血管事件相关性研究  

Correlation between Clopidogrel Response and Vascular Event in Neurointervention Surgery

作　　者：张磊[1] 梁迎春[1] 宁方波[1] 李洪军[1] 王涛[1] 

机构地区：[1]泰安市中心医院,山东泰安271000

出　　处：《神经损伤与功能重建》2015年第4期304-306,共3页Neural Injury and Functional Reconstruction

摘　　要：目的：探讨择期神经介入手术患者术前氯吡格雷反应性与血管事件关系。方法：选择行神经介入手术患者53例,以Verify Now-P2Y12系统检测患者术前血小板抑制率,随访患者术后30 d内血管事件的发生率。结果：所有患者均顺利完成手术和随访,无血管事件31例（58.49%）为无并发症组,缺血事件13例（24.53%）为缺血组,出血事件9例（16.98%）为出血组,无1例同时合并缺血和出血并发症。各组年龄、性别、病情、疾病等基础资料组间比较差异无统计学意义（P〉0.05）,但血小板抑制率出血组明显高于无并发症组,缺血组则低于无并发症组（P〈0.01）。血小板抑制率预测缺血事件ROC曲线下面积（AUC）为0.951（P〈0.01）,对应的血小板抑制率为27%,敏感性为92.31%,特异性为90.00%;血小板抑制率预测出血事件AUC为0.845（P=0.004）,对应的血小板抑制率为72%,此时敏感性为77.78%,特异性为95.45%。结论：Verify Now-P2Y12系统能有效预测神经介入手术患者术后血管事件的发生,理想治疗范围为27%~72%。Objective：To investigate the correlation between clopidogrel response and vascular events in neuroint- ervention surgery. Methods： The preoperative platelet inhibition rate of 53 patients who were received neurointer- vention surgery was detected by VerifyNow-P2Y12 system. The incidence of vascular events was followed-up within 30 days post-operation. Results： All the patients had completed surgery and been follow-up successfully. The number of cases without vascular events was 31 （58.49%, normal group）, 13 patients （24.53%, ischemia group） ex- perienced ischemic events, 9 patients （16.98%, bleeding group） had bleeding events. There was no significant dif- ference in age, sex, and other basic data between three groups （P〉0.05）, but the platelet inhibition rate of bleeding group was significantly higher than that in the normal group while the rate in the ischemia group were lower than those without complications （P〈0.01）. The ROC curve AUC of platelet inhibition rate in the ischemic group was 0.951 （P〈0.01）, platelet inhibition rate, sensitivity and specificity were 27%, 92.31% and 90.00% accordingly. The AUC ofplatelet inhibition rate in the bleeding group was 0.845 （P=0.004）. Accordingly, the platelet inhibition rate, sensitivity and specificity were 72%, 77.78% and 95.45% respectively. Conclusion： VerifyNow- P2Y12 system could predict vascular events in neurointervention surgery patients and the ideal therapeutic range was 27% to 72%.

关 键 词：神经介入 氯吡格雷 血小板抑制率 血管事件 

分 类 号：R741[医药卫生—神经病学与精神病学] R741.05[医药卫生—临床医学]