本文選題：尿毒癥　切入點：維持血液透析　出處：《山東醫(yī)藥》2017年23期 　論文類型：期刊論文

【摘要】：目的觀察冠脈支架置入術(shù)后發(fā)生支架內(nèi)狹窄的尿毒癥患者外周血血栓彈力圖檢查結(jié)果的變化,探討合并冠心病的尿毒癥患者冠脈支架置入術(shù)后發(fā)生支架內(nèi)狹窄的原因。方法選擇冠脈支架置入術(shù)后1年內(nèi)發(fā)生支架內(nèi)再狹窄的尿毒癥患者37例為觀察組,冠脈支架置入術(shù)后1年內(nèi)無支架內(nèi)再狹窄的尿毒癥患者34例為對照組。兩組患者術(shù)后均堅持服用氯吡格雷75 mg/d抗血小板。觀察組患者確診支架內(nèi)狹窄、對照組患者隨訪結(jié)束后,血液透析前1 d,空腹采集外周靜脈血。行血栓彈力圖(TEG)檢查,檢測血栓最大彈力度(MA值)和血小板二磷酸腺苷(ADP)受體抑制率。結(jié)果觀察組、對照組MA分別為64.6±5.7、58.9±5.4,血小板ADP受體抑制率分別為44.4%±13.3%、54.2%±12.3%。兩組MA和血小板ADP受體抑制率相比,P均0.05。結(jié)論冠脈支架置入術(shù)后狹窄的尿毒癥患者外周血TEG檢查結(jié)果 MA升高、血小板ADP受體抑制率下降。合并冠心病的尿毒癥患者冠脈支架置入術(shù)后發(fā)生支架內(nèi)狹窄的原因可能是氯吡格雷抵抗導(dǎo)致的血小板高反應(yīng)。
[Abstract]:Objective to observe the changes of thromboelastography in peripheral blood of uremia patients with stent stenosis after coronary stenting. To investigate the causes of in-stent stenosis in uremic patients with coronary heart disease after coronary stenting. Methods 37 uremic patients with restenosis within one year after coronary stenting were selected as the observation group. 34 patients with uremia without stent restenosis within one year after coronary stent implantation were taken as control group. The patients in both groups were treated with clopidogrel 75 mg/d anti-platelet. The patients in the observation group were diagnosed with stent stenosis and the control group was followed up. One day before hemodialysis, peripheral venous blood was collected on an empty stomach. Thromboelastography (TEG) was performed to detect the maximal elasticity of thrombus (MA) and the inhibition rate of platelet adenosine diphosphate (ADPP) receptor. In the control group, MA was 64.6 鹵5.7 鹵58.9 鹵5.4, and the inhibition rate of platelet ADP receptor was 44.4% 鹵13.33.34.2% 鹵12.3.The inhibition rate of MA and platelet ADP receptor in the two groups was 0.055.Conclusion the TEG examination of peripheral blood of uremic patients with stenosis after coronary stenting is higher than that of control group. In uremic patients with coronary heart disease, the cause of stent stenosis after coronary stenting may be the high platelet reaction caused by clopidogrel resistance.
【作者單位】： 中國人民解放軍第161醫(yī)院;
【基金】：全軍醫(yī)學(xué)科技青年培育項目(13QNP196)
【分類號】：R692.5
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本文編號：1623590