血小板功能检测在高血压合并急性脑梗死非溶栓患者抗栓治疗中的应用  

Application of platelet function test in antithrombotic treatment of non-thrombolytic patients with hypertension and acute cerebral infarction

作　　者：王晶晶 王超 刘敏[2] 李鹏辉 谢颂扬 吴莉莉 WANG Jingjing;WANG Chao;LIU Min;LI Penghui;XIE Songyang;WU Lili(The First Provincial Hospital,Henan Provincial People's Hospital,Zhengzhou 450003,China;Henan Provincial People's Hospital,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院省直第一医院,河南郑州450003 [2]河南省人民医院,河南郑州450003

出　　处：《中国实用神经疾病杂志》2020年第2期114-118,共5页Chinese Journal of Practical Nervous Diseases

基　　金：国家自然科学基金(编号:81570274)。

摘　　要：目的评价血小板功能检测在高血压合并急性脑梗死非溶栓患者的抗栓治疗监测中的应用价值,探讨抗血小板药物治疗反应多样性。方法选择335例于2018-01—2019-06住院的未溶栓的确诊高血压合并急性脑梗死患者为研究对象,根据不同的抗血小板药物种类和剂量分组阿司匹林200 mg治疗组、阿司匹林100 mg治疗组、氯吡咯雷治疗组、替格瑞洛治疗组。采用比浊法分别检测各组治疗前后AA、ADP、Col、EPI诱导的MAR。结果治疗7 d后,各治疗组MARADP、MARAA、MARCol、MAREPI较治疗前均下降,差异有统计学意义(P<0.05)。氯吡格雷治疗组及替格瑞洛治疗组MARADP差值高于不同剂量阿司匹林治疗组,差异有统计学意义(P<0.05)。不同剂量阿司匹林治疗组MARAA差值均高于氯吡格雷治疗组及替格瑞洛治疗组,差异有统计学意义(P<0.05);阿司匹林200 mg治疗组MARAA差值高于阿司匹林100 mg治疗组,差异有统计学意义(P<0.05)。结论阿司匹林、氯吡咯雷、替格瑞洛均能有效降低高血压合并急性脑梗死非溶栓患者的血小板最大聚集率,阿司匹林200 mg比阿司匹林100 mg剂量的抗血小板效果更佳。Objective To evaluate the application value of platelet function test in the monitoring of anti-thrombotic therapy in patients with hypertension and acute cerebral infarction and investigate the diversity of anti-platelet drug responses.Methods 335 patients with hypertension and acute cerebral infarction hospitalized from January 2018 to June 2019 were selected as objects.These patients were divided into 4 different treatment groups according to different kinds(clopidogrel and tegrilol)and doses of anti-platelet drugs(aspirin 200 mg;aspirin 100 mg).The MAR induced by AA,ADP,Col and EPI were detected by using turbidimetry,and then the data were analyzed.Results After 7 days post treatment,the levels of MARADP,MARAA,MARCol and MAREPI were reduced with statistically significant differences.The level of MARADP in the clopidogrel treatment group and ticagrelor treatment group was higher than that of the aspirin treatment groups,and the difference was statistically significant(P<0.05).The level of MARAA in aspirin treatment groups was higher than that of the clopidogrel treatment group and ticagrelor treatment group,the difference is statistically significant(P<0.05).Additionally,the level of MARAA in aspirin 200 mg treatment group was higher than that of the 100 mg treatment group,and the difference was statistically significant(P<0.05).Conclusion Aspirin,clopidogrel and tegrilol could reduce the maximum platelet aggregation rate in patients with hypertension and acute cerebral infarction,which had effective anti-platelet effect.The higher dose of Aspirin treatment with 200 mg had a better effect of anti-platelet aggregation than that of 100 mg.

关 键 词：脑梗死 血小板功能检测 血小板最大聚集率 抗栓治疗 血小板药物治疗反应多样性 

分 类 号：R743.33[医药卫生—神经病学与精神病学]