血小板功能检测对复杂性PCI术后患者临床结局的预测  

Prediction of clinical outcomes with platelet function testing in patients after complex percutaneous coronary intervention

作　　者：廉铮[1] 吕峰峰[1] 王家旺 Lian Zheng;Lyu Fengfeng;Wang Jiawang(Department of Cardiovascular Medicine,Central Hospital of Cangzhou City,Hebei Province,Cangzhou 061000,China)

机构地区：[1]河北沧州市中心医院心血管内科,沧州061000

出　　处：《中国循证心血管医学杂志》2018年第10期1198-1201,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：河北省医学科学研究重点课题计划(20150974)

摘　　要：目的研究血小板功能检测(PFT)对复杂性经皮冠脉介入治疗(PCI)术后患者临床结局的预测。方法选择从2014年1月～2016年3月于河北沧州市中心医院进行复杂性PCI治疗的冠状动脉粥样硬化性心脏病(冠心病)患者117例进行研究。将117例患者根据是否存在高血小板活性(HTPR),即二磷酸腺苷(ADP)≥40%,分成观察组(HTPR组)56例和对照组(非HTPR组)51例。对比两组一般资料,随访1年,对两组临床结局进行对比,并对患者的主要的不良心脑血管类事件(MACCE)分别进行单因素及多因素的Cox分析,分析患者HTPR与临床结局的相关性。结果观察组的年龄、平均ADP聚集度及陈旧性心肌梗死的比例均分别明显高于对照组,差异均有统计学意义(P均<0.05)。观察组MACCE的发生率为16.07%,明显高于对照组的3.92%,差异有统计学意义(P<0.05)。根据多因素的Cox分析发现,HTPR(HR=2.678,P=0.013,95%CI:1.206～5.833)是患者产生MACCE的一个独立危险因素。结论 PFT检测对于复杂性PCI术后患者的临床结局具有较好的预测作用,HTPR患者MACCE的发生率更高,且HTPR是患者产生MACCE的一个独立危险因素,并且与MACCE呈正相关。临床上可考虑检测PFT以更好地评估患者的临床结局,值得关注。Objective To study the prediction of clinical outcomes with platelet function testing(PFT)in patients after complex percutaneous coronary intervention(PCI).Methods The patients with coronary heart disease(CHD,n=117)received PCI were chosen from the Central Hospital of Cangzhou City of Hebei Province from Jan.2014 to Mar.2016.All 117 patients were divided,according to whether or not having high on-treatment platelet reactivity(HTPR,ADP≥40%),into observation group(HTPR group,n=56)and control group(non-HTPR group,n=51).The clinical data was compared,and after followed up for 1 y,the clinical outcomes were compared between 2 groups.The major adverse cardiovascular and cerebrovascular events(MACCE)were given single-factor and multi-factor Cox analysis,and correlation between HTPR and clinical outcomes was analyzed in all patients.Results The age,ADP aggregation degree and percentages of patients with old myocardial infarction were significantly higher in observation group than those in control group(all P<0.05).The incidence of MACCE was 16.07%in observation group and 3.92%in control group(P<0.05).The results of multi-factor Cox analysis showed that HTPR(HR=2.678,P=0.013,95%CI:1.206~5.833)was an independent risk factor of MACCE.Conclusion PFT has a good predictive effect on clinical outcomes in CHD patients undergone complex PCI.The incidence of MACCE was higher in HTPR patients,and HTPR is an independent risk factor of MACCE and is positively correlated to MACCE.The detection of PFT can be used to review clinical outcomes in CHD patients in clinical practice.

关 键 词：血小板 经皮冠脉介入治疗 危险因素 预测 

分 类 号：R816.2[医药卫生—放射医学]