血小板功能检测在复杂PCI患者预后评估中的应用价值  

Application value of platelet function test in prognosis review in patients undergone complex percutaneous coronary intervention

作　　者：张岩[1] 王文璐 王琦[1] Zhang Yan;Wang Wenlu;Wang Qi(Municipal Hospital of Qingdao City,Qingdao 266011,China)

机构地区：[1]青岛市市立医院,青岛266011

出　　处：《中国循证心血管医学杂志》2018年第6期733-736,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的分析血小板功能(PTF)检测在复杂经皮冠状动脉介入治疗(PCI)患者预后评估中的应用价值。方法回顾性分析2014年3月~2016年3月于青岛市市立医院行复杂PCI治疗的冠状动脉粥样硬化性心脏病(冠心病)患者的126例病例资料,分别检测PCI术后1、6和12个月的PTF。根据二磷酸腺苷(ADP)诱导的平均血小板聚集度分为高血小板活性(HTPR)组(ADP≥40%)64例和非HTPR组(ADP<40%)62例,HTPR组又分为标准双联抗血小板治疗(DAPT)亚组(25例)和延长DAPT亚组(39例)。随访观察患者的主要不良心脑血管事件(MACCE)发生率。采用Cox风险模型分析影响MACCE发生的因素,Kaplan-Meier分析组间MACCE发生率。结果 126例患者均完成随访(随访率100%),随访期间HTPR组6例MACCE(9.38%),非HTPR组1例(1.61%),经Kaplan-Meier分析HTPR组的MACCE发生率明显高于非HTPR组(P<0.05);经Cox多因素分析显示,HTPR是进行复杂PCI冠心病患者发生MACCE的独立危险因素(HR=2.684,95%CI:1.245~5.863,P=0.012)。术后不同时间的DAPT亚组间MACCE的发生率无显著差异(P>0.05)。结论接受复杂PCI的冠心病患者术后PTF检测,对预后评估有较高应用价值。Objective To analyze the application value of platelet function(PTF)test in prognosis review in patients undergone complex percutaneous coronary intervention(PCI).Methods The clinical materials from patients with coronary heart disease(CHD,n=126)undergone complex PCI were retrospectively analyzed in Municipal Hospital of Qingdao City from Mar.2014 to Mar.2016.PTF was detected respectively after the operation for 1 month,6 months and 12 months.The patients were divided,according to platelet aggregation(PAG)induced by adenosine diphosphate(ADP),into high platelet reactivity group(HTPR group,ADP≥40%,n=64)and non-HTPR group,ADP<40%,n=62).HTPR were divided further into standard dual anti-platelet therapy(DAPT)subgroup(DAPT subgroup,n=25)and prolonged DAPT subgroup(n=39).The incidence of major adverse cardiovascular and cerebrovascular events(MACCE)was followed up and observed in the patients.The influencing factors on incidence of MACCE were analyzed by using Cox risk model,and incidence of MACCE was analyzed by using Kaplan-Meier analysis among all groups.Results All 126 patients completed follow-up(follow-up rate was 100%),and there were 6(9.38%)cases of MACCE in HTPR group,and 1(1.61%)case of MACCE in non-HTPR group.Kaplan-Meier analysis showed that incidence of MACCE was significantly higher in HTPR group than that in non-HTPR group(P<0.05).Cox multi-factor analysis showed that HTPR was an independent risk factor of MACCE in CHD patients undergone complex PCI(HR=2.684,95%CI:1.245~5.863,P=0.012).The incidence of MACCE had no significant difference among different DAPT subgroups after the operation at different time points(P>0.05).Conclusion PTF test has higher application value in prognosis review after the operation in CHD patients undergone complex PCI.

关 键 词：血小板功能检测 冠心病 复杂PCI 预后评估 

分 类 号：R541.4[医药卫生—心血管疾病]