氯吡格雷抵抗对老年急性冠脉综合征患者经皮冠脉介入治疗预后的影响分析  

Analysis of the effect of clopidogrel resistance on the prognosis of elderly patients with acute coronary syndrome undergoing percutaneous coronary intervention

作　　者：付昱权 FU Yu-quan(The First People's Hospital of Yihuang County,Fuzhou 344400,China)

机构地区：[1]江西省抚州市宜黄县第一人民医院,344400

出　　处：《中国实用医药》2024年第22期100-103,共4页China Practical Medicine

摘　　要：目的分析氯吡格雷抵抗对老年急性冠状动脉(冠脉)综合征(ACS)患者经皮冠脉介入治疗预后的影响。方法选取100例老年急性冠脉综合征患者作为研究对象,两组患者均采用经皮冠脉介入治疗,且手术前后服用氯吡格雷与阿司匹林治疗。依据治疗前后血小板聚集率下降情况将患者分为氯吡格雷抵抗组(观察组)和非氯吡格雷抵抗组(对照组),每组50例。对比两组患者不良事件发生情况、血小板活性指标、炎症因子水平、再次住院情况。结果观察组患者不良事件发生率26.00%高于对照组的10.00%(P<0.05)。治疗后,观察组血栓素B2(TXB2)(61.51±7.47)ng/L、血小板膜蛋-140(GMP-140)(11.28±2.51)%、半胱天冬酶原活化复合物-1(PAC-1)(8.32±2.57)%低于对照组的(65.33±9.21)ng/L、(12.31±2.14)%、(9.41±2.12)%,组间对比差异有统计学意义(t=2.278、2.208、2.313,P<0.05)。治疗后,观察组白细胞介素-6(IL-6)(8.61±4.18)ng/L、白细胞介素-8(IL-8)(134.49±42.73)ng/L、超敏C反应蛋白(hs-CRP)(2.24±1.76)mg/L、肿瘤坏死因子-α(TNF-α)(4.86±2.34)ng/L低于对照组的(11.35±4.24)ng/L、(169.25±51.46)ng/L、(4.24±2.49)mg/L、(7.36±3.54)ng/L,组间对比差异有统计学意义(t=3.254、3.675、4.638、4.166,P<0.05)。观察组患者的再次住院率38.0%高于对照组的18.0%,组间对比差异有统计学意义(χ^(2)=4.960,P=0.026<0.05)。结论老年急性冠脉综合征患者进行经皮冠脉介入治疗后有氯吡格雷抵抗情况出现,并且在一定程度上会促进患者心血管不良事件的发生,有效抑制血小板活性及炎症反应,促进患者病情稳定。Objective To analyze the effect of clopidogrel resistance on the prognosis of elderly patients with acute coronary syndrome(ACS)undergoing percutaneous coronary intervention.Methods 100 elderly patients with acute coronary syndrome were selected as the study subjects.Both groups were treated with percutaneous coronary intervention and clopidogrel and aspirin before and after surgery.Based on the decrease in platelet aggregation rate before and after treatment,the patients were divided into a clopidogrel resistance group(observation group)and a non clopidogrel resistance group(control group),with 50 patients in each group.The occurrence of adverse events,platelet activity indices,inflammatory factor level and re-hospitalization were compared between the two groups.Results The incidence of adverse events of 26.00%in the observation group was higher than 10.00%in the control group(P<0.05).After treatment,the observation group had thromboxane B2(TXB2)of(61.51±7.47)ng/L,granule membrane protein-140(GMP-140)of(11.28±2.51)%and procaspase-activating compound 1(PAC-1)of(8.32±2.57)%,which were lower than(65.33±9.21)ng/L,(12.31±2.14)%and(9.41±2.12)%in the control group.The difference between groups was statistically significant(t=2.278,2.208,2.313;P<0.05).After treatment,the observation group had interleukin-6(IL-6)of(8.61±4.18)ng/L,interleukin-8(IL-8)of(134.49±42.73)ng/L,hypersensitive C-reactive protein(hs-CRP)of(2.24±1.76)mg/L,and tumor necrosis factor-α(TNF-α)of(4.86±2.34)ng/L,which were lower than(11.35±4.24)ng/L,(169.25±51.46)ng/L,(4.24±2.49)mg/L,and(7.36±3.54)ng/L in the control group.The difference between the two groups was statistically significant(t=3.254,3.675,4.638,4.166;P<0.05).The re-hospitalization rate of 38.0%in the observation group was higher than 18.0%in the control group,and the difference between the two groups was statistically significant(χ^(2)=4.960,P=0.026<0.05).Conclusion Patients with acute coronary syndrome experience resistance to clopidogrel after percutaneous coronary interv

关 键 词：氯吡格雷抵抗 急性冠状动脉综合征 经皮冠状动脉介入治疗 预后 血小板活性 炎症因子 

分 类 号：R541.4[医药卫生—心血管疾病]