择期行CABG术患者停用抗血小板药物对血小板聚集率的影响  

Influence of platelet aggregation inhibition after withdrawal of antiplatelet therapy among coronary artery disease patients before CABG surgery

作　　者：徐卓文[1] 郑若龙[1] 陈新军[1] 李伟章[1] 李春坚[2] 杨志健[2] 

机构地区：[1]东南大学医学院附属江阴医院心内科,江苏省江阴市214400 [2]南京医科大学第一附属医院心脏科

出　　处：《中国心血管病研究》2017年第8期715-719,共5页Chinese Journal of Cardiovascular Research

摘　　要：目的 探讨择期行冠状动脉旁路移植手术（CABG）的冠心病（CAD）患者停用阿司匹林和氯吡格雷后对血小板聚集功能的影响.方法 24例经冠状动脉造影（CAG）提示需行CABG术的冠心病患者,连续口服100 mg肠溶阿司匹林和75 mg氯吡格雷1周,观察停药后1、2、3、4、5、6、7、9天血小板聚集率的变化.采用光学血小板聚集仪（LTA）测定花生四烯酸诱导的血小板聚集率（PL-AA）和二磷酸腺苷诱导的血小板聚集率（PL-ADP）.结果 停药后第1天AA诱导的血小板聚集抑制效应最强[（5.4±1.6）％],血小板功能在停药后第4天恢复至正常水平[（76.6±4.0）％];停药后第1天ADP诱导的血小板聚集抑制效应最强[（29.5±12.1）％],在停药后第7天恢复至正常水平[（69.7±3.5）％.结论 冠心病患者口服100 mg阿司匹林和75 mg氯吡格雷1周,停药后AA诱导的血小板聚集功能第4天恢复至正常;ADP诱导的血小板聚集功能在第7天恢复至正常.Objective To evaluate the time course of platelet aggregation inhibition after discontinuing antiplatelet therapy among coronary artery disease patients prior to the CABG surgery.Methods 24 coronary artery disease（CAD） patients scheduled for elective CABG who have taken Aspirin（100 mg） and Clopidogrel（75 mg）daily for at least 7 days.Platelet aggregations were measured by light transmission aggregometry triggered with 1 mmol/L arachidonic acid（PL-AA） and 5 μmol/L adenosine diphosphate（PL-ADP） on days 1,2,3,4,5,6,7 and 9 after the last dose of the study drugs.Results AA-induced platelet aggregation was maximally suppressed on day 1 after completion of drug treatment （5.4±1.6）％.Platelet function began to recover on day 3 and returned to normal by day 4 （76.6±4.0）％.ADP-induced platelet aggregation was maximally inhibited on day 1 after completion of drug treatment（29.5±12.1）％ and returned to normal by day 7（69.7±3.5）％.Conclusion Platelet aggregations triggered with arachidonic acid returned to normal by day 4 among coronary artery disease patients prior to the CABG surgery,and platelet aggregations triggered with adenosine diphosphate returned to normal levels by day 7 among coronary artery disease patients prior to the CABG surgery.

关 键 词：冠状动脉旁路移植术 血小板聚集率 花生四烯酸 二磷酸腺苷 

分 类 号：R541.4[医药卫生—心血管疾病]