尿酸对老年冠心病患者介入术后凝血及血小板功能的影响  

Effect of uric acid on blood coagulation and platelet function in elderly coronary heart disease patients following PCI

作　　者：王婷[1] 夏大胜[2] 何强[2] 叶绪英[2] 梁景一 

机构地区：[1]天津医科大学一中心临床学院,300192 [2]天津市第一中心医院心内科

出　　处：《中华老年心脑血管病杂志》2016年第6期593-596,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨血尿酸对老年冠心病患者PCI术后凝血及血小板功能的影响。方法选取行PCI术的老年冠心病患者110例,并按照血清尿酸水平分为高尿酸血症组41例和对照组69例,患者于术后1周行血栓弹力图检测,比较2组患者的凝血功能和血小板二磷酸腺苷(ADP)抑制率(ADP%)、花生四烯酸(AA)抑制率(AA%)。同时记录凝血反应时间(R值)、血凝块形成时间(K值)、血凝块形成的最大幅度(MA值)和血凝块形成的速率(α角)。结果与对照组比较,高尿酸血症组的R值[(5.88±1.50)min vs(7.16±2.06)min,P=0.001]、K值[(2.15±0.63)min vs(2.58±0.88)min,P=0.007]、ADP%[(53.94±24.62)%vs(73.26±18.56)%,P=0.000]、AA%[(60.06±23.43)%vs(79.59±15.98)%,P=0.000]显著降低,MA值[(65.57±3.15)mmvs(59.01±6.99)mm,P=0.000]、α角[(64.69±5.24)°vs(56.51±4.86)°,P=0.000]显著增高。血尿酸与R值、K值、ADP%、AA%呈负相关(P<0.05,P<0.01),与MA值、α角呈正相关(P<0.01)。血尿酸与ADP%、AA%独立负相关(P<0.05)。结论合并高尿酸血症的老年冠心病患者PCI术后血液呈高凝状态,血小板活性高,阿司匹林抵抗和氯吡格雷抵抗发生率高。Objective To study the effect of uric acid（UA）on blood coagulation and platelet function in elderly coronary heart disease（CHD）patients following PCI.Methods One hundred and ten elderly CHD patients were divided into hyperuricemia group（n=41）and control group（n=69）according to their serum UA level.Their blood coagulation and platelet ADP inhibition rate（ADP%）and platelet AA inhibition rate（AA%）were assayed by thrombelastography.The blood coagulation reaction time（R value）,clot formation time（K value）,maximal amplitude of clot formation（MA value）,and clot formation speed（αangle）were recorded.Results The R value,K value,ADP% and AA% were significantly lower whereas the MA value andαangle were significantly higher in hyperuricemia group than in control group（5.88±1.50 min vs 7.16±2.06 min,P=0.001;2.15±0.63 min vs 2.58±0.88 min,P=0.007;53.94% ±24.62% vs 73.26% ±18.56%,P=0.000;60.06% ±23.43% vs 79.59% ±15.98%,P=0.000;65.57±3.15 mmvs59.01±6.99 mm,P=0.000;64.69±5.24°vs56.51±4.86°,P=0.000）.The serum UA level was negatively related with the R value,K value,ADP%,AA%（P〈0.05,P〈0.01）,positively related with the MA value andαangle（P〈0.01）,independently and negatively related with ADP% and AA%（P〈0.05）.Conclusion Platelet aggregation activity and clopidogrel and asprin resistance are high in elderly CHD patients with hyperuricemia following PCI.

关 键 词：冠心病 血栓弹力描记术 腺苷二磷酸 花生四烯酸类 阿司匹林 

分 类 号：R541.4[医药卫生—心血管疾病]