本文選題：血栓彈力圖 + 氯吡格雷��； 參考：《首都醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的利用血栓彈力圖(Thromboelastograph,TEG)評價在經(jīng)皮冠狀動脈介入治療(Percutaneous Coronary Intervention,PCI)術(shù)后的冠心病患者中,發(fā)生氯吡格雷反應(yīng)低下的影響因素。方法選取接受PCI的冠心病患者158例,術(shù)前1天均予口服負(fù)荷劑量阿司匹林300mg和氯吡格雷300mg抗血小板治療,次日晨起空腹時接受血栓彈力圖檢查,以二磷酸腺苷(adenosine diphosphate,ADP)誘導(dǎo)的血小板聚集抑制率小于30%為氯吡格雷反應(yīng)低下,比較氯吡格雷反應(yīng)低下與氯吡格雷非反應(yīng)低下患者的臨床資料、生化指標(biāo)及影像學(xué)參數(shù),通過Logistic回歸分析氯吡格雷反應(yīng)低下的危險因素。結(jié)果總計78例患者出現(xiàn)氯吡格雷反應(yīng)低下,發(fā)生率為49.4%。兩組患者在性別構(gòu)成、糖尿病史方面的差異有統(tǒng)計學(xué)意義(P0.05),在其余各項生化指標(biāo)及影像學(xué)參數(shù)的差異均無統(tǒng)計學(xué)意義(P0.05)。Logistic回歸分析結(jié)果顯示氯吡格雷反應(yīng)低下的獨立危險因素包括女性(P=0.003,OR=2.807,95%CI=1.406~5.605)以及糖尿病史(P=0.033,OR=2.061,95%CI=1.059~4.011)。結(jié)論女性及糖尿病史可能是冠心病患者PCI術(shù)后發(fā)生氯吡格雷反應(yīng)低下的危險因素。
[Abstract]:Objective to evaluate the risk factors of low clopidogrel response in patients with coronary heart disease after percutaneous coronary intervention (PCI) with thromboelastography (TEG). Methods 158 patients with coronary heart disease who received PCI were given antiplatelet therapy with aspirin 300mg and clopidogrel 300mg one day before operation, and thromboelastography was performed on an empty stomach the next morning. The inhibition rate of platelet aggregation induced by adenosine diphosphate was lower than 30%. The clinical data, biochemical indexes and imaging parameters of patients with low clopidogrel reaction and clopidogrel non-response were compared. Logistic regression analysis was used to analyze the risk factors of low clopidogrel reaction. Results there were 78 patients with low clopidogrel reaction (49.4%). Two groups of patients in the gender composition, There were significant differences in the history of diabetes mellitus (P0.05), but there was no significant difference in other biochemical and imaging parameters (P0.05). Logistic regression analysis showed that the independent risk factors for low clopidogrel reaction included women (P0. 003 OR2.807 + 95CII 1.4065.605) and diabetes history (P0.033 OR2.061 95CII 1.0594.011). Conclusion the history of women and diabetes may be the risk factors of low clopidogrel reaction after PCI in patients with coronary heart disease.
【學(xué)位授予單位】：首都醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R541.4

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