| 朱晓龙 鱼龙浩 查 理 李学奇 金恩泽.阿司匹林、氯吡格雷及西洛他唑预防和治疗老年冠脉支架植入术后血小
板高反应性的临床效果观察[J].,2015,15(7):1281-1285 |
| 阿司匹林、氯吡格雷及西洛他唑预防和治疗老年冠脉支架植入术后血小
板高反应性的临床效果观察 |
| Clinical Research on the Effect of Asprine, Clopidogrel and Cilostazol on thePrevention and Treatment of Elderly Patients Planning for PercutaneousCoronary Intervention |
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| DOI： |
| 中文关键词: 西洛他唑 血小板 药物洗脱支架 |
| 英文关键词: Cilostazol Platelet Drug-eluting stents |
| 基金项目:黑龙江省留学归国科学基金项目（ LC2011 C10） |
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| 中文摘要: |
| 目 的： 探讨阿司 匹林、氯吡格雷及西洛他唑预防和治疗 老年冠脉支架植入术后血小板高反应性的临床效果。 方法： 选择 60
例 拟行冠脉支架植入术的老年患者， 随机地分为加用 或未加用 200 mg 西洛他唑负荷剂 量组。术前、术后 24 小时及术后 30 天时
检测和比较各组患者的血小板聚集功能。 结果： 三联抗血小板治疗组的 PRU、 ARU 及 P2Y1 2 % inhibition 值均较两联抗血小板治
疗 组显著降低，差异具有统计学意义(P<0.05)。 三联抗血小板治疗和两联负荷剂量的抗血小板治疗的给药时间 (第一次投药至冠脉
介入治疗 的时间间 隔)分别 为 10.2 小时(95%可信区间： 7.4-1 3.1 小时)和 7.8 小时(95%可信区间： 4.5-11 .2 小时)， 三联抗血小板治
疗 组术前 HPPR (83.3%和 46.7%， P=0.003)、术后 24 小时(36.7%和 13.3%， P=0.018)及术后 30 天 HPPR (40.0%和 1 6.7%， P=0.045)
的发生率均较两联抗血小板治疗组明显降低(P<0.05)。 在术后 30 天的随访观察期间 ， 两联抗血小板治疗 组 2 例 患者出现支架内
血栓，并进行了 血运重建术； 无 1 例心源性死亡、缺血性卒中及出血性并发症的发生。 两组次要终点的发生率比较无显著性差异
(P>0.05)。 结论： 在两联抗血小板聚集治疗 的基础上附加 200 mg 西洛他唑可显著降低冠状动脉支架植入术后血小板的高反应性。 |
| 英文摘要: |
| Objective:To investuge the clinical efficacy of asprine, clopidogrel and cilostazol in the prevention and treatment of
elderly patients Planning for Percutaneous Coronary Intervention.MethodsSixty elderly patients undergoing coronary intervention were
enrolled and randomly treated by 300 mg of aspirin and clopidogrel with or without 200 mg of cilostazol. All loading doses were given at
least 3 h before percutaneous coronary intervention and followed by dual or triple maintenance-dose therapy. The platelet function tests
were performed just before and at 24 h and 30 days after percutaneous coronary intervention by light transmittance aggregometry and
VerifyNow P2Y12 assay.:Results:The P2Y1 2 reaction units (PRU), aspirin reaction units (ARU) and P2Y1 2 % inhibition value were
significantly decreased in the triple antiplatelet therapy group than those of the dual antiplatelet therapy group(P<0.05). The time interval
of loading doses, dose-to-PCI time were 10.2 hours (95% CI: 7.4-1 3.1 hours) in the triple antiplatelet therapy group, and 7.8 hours (95%
CI: 4.5-11 .2 hours) in the dual antiplatelet therapy group. The HPR rates were significantly reduced in the triple antiplatelet therapy group
than those of the dual platelet therapy group before coronary interventin (83.3% and 46.7%, P=0.003), at 24 hours (36.7% and 1 3.3%,
P=0.018) and 30 days (40.0% and 16.7%, P=0.045) after coronary intervention. During the 30 days' follow-up period, 2 cases of in-stent
thrombosis were found in the dual antiplatelet therapy group and received coronary revascularization; no cardiac death, ischemic stroke
and bleeding complications was found. There was no significant difference in the incidence of secondary end points between two groups
(P>0.05).Conclusion:Adjunctive 200 mg cilostazol in addition to the dual antiplatelet therapy could significantly reduce the incidence of
HPR after coronary stent intervention. |
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