| 禹 霞,牛晓珊,张岩鹏,王菲菲,李 菲.血栓弹力图指导抗血小板个性化治疗对非心源性缺血性卒中患者AA抑制率、ADP抑制率及Lp-PLA2水平的影响[J].,2022,(17):3303-3308 |
| 血栓弹力图指导抗血小板个性化治疗对非心源性缺血性卒中患者AA抑制率、ADP抑制率及Lp-PLA2水平的影响 |
| Thromboelastic Chart-guided Anti-platelet Personalized Therapy on AA Suppression rate, ADP Suppression Rate and Lp-PLA2 Level in Patients with Non-cardiac Ischemic Stroke |
| 投稿时间：2022-03-06 修订日期：2022-03-29 |
| DOI：10.13241/j.cnki.pmb.2022.17.020 |
| 中文关键词: 血栓弹力图 抗血小板个性化治疗 非心源性缺血性卒中患者 |
| 英文关键词: Thromboelastography Personalized antiplatelet therapy Patients with non-cardiac ischemic stroke |
| 基金项目:新疆维吾尔自治区自然科学基金项目（2020D01C089） |
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| 中文摘要: |
| 摘要 目的：观察应用血栓弹力图指导抗血小板个性化治疗对非心源性缺血性卒中患者AA抑制率、ADP抑制率及脂蛋白相关磷脂酶A2（Lp-PLA2）水平的影响。方法：将本院2019年4月-2022年4月收治的110例非心源性缺血性卒中患者为研究对象，根据随机数字表法随机分为研究组（给予个性化治疗）和对照组（给予常规治疗）各55例。统计两组AA抑制率、ADP抑制率的起效、达标情况及Lp－PLA2水平，用药不同组AA抑制率、ADP抑制率的起效、达标情况及Lp－PLA2水平及两组AA抑制率、ADP抑制率的起效、达标时间，并统计1年内随访结果。结果：研究组AA抑制率、ADP抑制率起效、达标情况均优于对照组，Lp－PLA2水平较对照组低（P＜0.05）；阿司匹林联合氯吡格雷用药的AA抑制率、ADP抑制率起效、达标情况均优于阿司匹林及氯吡格雷，且Lp－PLA2水平低于阿司匹林及氯吡格雷（P＜0.05）；氯吡格雷AA抑制率达标率明显低于阿司匹林（P＜0.05）；氯吡格雷ADP抑制率起效、达标率明显高于阿司匹林（P＜0.05）；而两组Lp－PLA2水平比较，差异不显著（P＞0.05）。研究组AA抑制率、ADP抑制率的起效、达标时间均低于对照组（P＜0.05）；本研究所有患者均完成为期1年的随访。随访期间，研究组临床终点事件发生率均低于对照组（P＜0.05）。结论：应用血栓弹力图可指导非心源性缺血性卒中患者抗血小板个性化治疗，以提高AA抑制率、ADP抑制率，降低Lp-PLA2水平，值得临床推广使用。 |
| 英文摘要: |
| ABSTRACT Objective: To observe the effect of using thromboelastography to guide anti-platelet personalized therapy on AA suppression rate, ADP suppression rate and Lp-PLA2 level in patients with non-cardiac ischemic stroke. Methods: A total of 110 patients with first noncardiac ischemic stroke admitted from April 2019 to April 2022 were randomly divided into study group (personalized treatment) and matched group (conventional treatment) according to the randomized number table method. There were 55 cases each in the matched group (given conventional treatment). Statistics of the two groups of AA refusal rate, the onset and achievement of ADP refusal rate and the level of Lp-PLA2, the AA refusal rate of different groups of medication, the onset and achievement of ADP refusal rate, the level of Lp-PLA2 and the two groups The onset of AA and ADP dependence rate, the time to reach the standard, and the follow-up results within 1 year. Results: The study group's AA repressive rate, ADP repressive rate onset and compliance were better than those of the matched group, and the Lp-PLA2 level was lower than that of the matched group (P<0.05); AA repressive treatment of aspirin combined with clopidogrel The rate of onset and achievement of ADP repression rate were better than that of aspirin and clopidogrel, and the level of Lp-PLA2 was lower than that of aspirin and clopidogrel (P＜0.05); the rate of compliance with clopidogrel AA reversion rate lower than aspirin (P<0.05); the onset and compliance rate of clopidogrel ADP was higher than that of aspirin (P<0. 05); while the two groups of Lp-PLA2 levels were not different (P>0.05). The onset and standard time of the AA repressive rate and ADP repressive rate of the study group were lower than those of the matched group (P＜0.05); all patients in this study completed the 1-year follow-up. During the follow-up period, the incidence of clinical endpoint events in the study group was lower than that in the matched group (P<0.05). Conclusion: The application of thromboelastography can guide the personalized antiplatelet therapy of patients with non-cardiac ischemic stroke, so as to increase the rate of AA suppression, ADP suppression, and reduce the level of Lp-PLA2. It is worthy of clinical application. |
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