尿酸对急性冠脉综合征患者PCI术后氯吡格雷抗血小板作用的影响  

Effect of uric acid on clopidogrel antiplatelet activity in patients with acute coronary syndrome after PCI

作　　者：蔡飞 崔翰斌[1] Fei;CUI Hanbin(Department of Cardiology, Ningbo First Hospital, Ningbo 315010, China)

机构地区：[1]浙江省宁波市第一医院心内科,315010 [2]浙江省宁波市中医院心内科

出　　处：《心电与循环》2019年第3期193-196,共4页Journal of Electrocardiology and Circulation

摘　　要：目的分析尿酸对男性急性冠脉综合征(ACS)患者PCI术后氯吡格雷抗血小板作用的影响。方法纳入男性ACS患者143例,根据尿酸水平分为高尿酸组(67例)和正常尿酸组(76例)。服用氯吡格雷片(75mg,1次/d)和拜阿司匹林片(100mg,1次/d)1周后采集外周静脉血,通过VerifyNow P2Y12方法测定血小板反应性(用PRU值表示)及血小板抑制率。随访观察两组患者PCI术后的主要心血管事件。结果两组TG、HDL-C、肌酐差异均有统计学意义(均P<0.05)。高尿酸组PRU值高于正常尿酸组(219.64±56.14vs183.93±60.68,P<0.05),血小板抑制率低于正常尿酸组[(18.16±20.86)%vs(26.09±20.69)%,P<0.05]。多因素分析显示尿酸是PRU值的独立影响因素(P<0.01)。两组基因型构成比差异无统计学意义。结论高尿酸血症男性ACS患者,氯吡格雷的血小板抑制作用减弱。Objective To explore the effect of uric acid on clopidogrel antiplatelet activity in male patients with acute coronary syndrome(ACS) after PCI. Methods 143 male patients with ACS were enrolled and divided into hyperuri-cemia group(67 cases) and normal uric acid group(76 cases). Peripheral venous blood was collected one week latter after treated with clopidogrel 75 mg daily and aspirin 100 mg daily. Platelet reactivity(PRU) and platelet inhibition rate were measured by VerifyNow P2 Y12 method. The main cardiovascular events after PCI were recorded during followed up period.Results There were significant differences in triglyceride, high density lipoprotein and creatinine between the two groups(all P<0.05). There was no significant difference in genotype composition between the two groups. The PRU was significantly higher and platelet inhibition rate was significantly lower in hyperuricemia group than in normal uric acid group(219.64±56.14 vs 183.93±60.68, P<0.05, 18.16±20.86)% vs.(26.09±20.69)%, respectively, all P<0.05]. Multivariate analysis showed that uric acid was an independent factor affecting PRU(P<0.01). Conclusion The inhibition effect of clopidogrel on platelet decreases in male ACS patients with hyperuricemia.

关 键 词：尿酸 氯吡格雷 血小板 急性冠状动脉综合征 

分 类 号：R541.4[医药卫生—心血管疾病]