冠心病心绞痛患者经皮冠状动脉介入围手术期对阿司匹林和氯吡格雷抗血小板效应分析

摘要目的：观察因冠心病心绞痛行经皮冠状动脉介入治疗（PCI）的患者，分析比较不稳定型心绞痛（ua）与稳定型心绞痛（SA）患者PCI围手术期对阿司匹林和氯吡格雷的抗血小板效应。方法：人选2013年3月～6月在北京市石景山医院行PCI术的患者103例，根据病情分为UA组及SA组。其中UA58例，SA45例。2组患者在糖尿病、PCI支架置人个数方面无显著差异。PCI术前24h口服300mg氯吡格雷、300mg阿司匹林，PCI术后继续服用氯吡格雷75mg／d，阿司匹林100mg／d，术后24h测定血栓弹力图，分析阿司匹林、氯吡格雷的血小板抑制率。结果：UA组的血小板抑制率：氯吡格雷（66．41±17．24）％，阿司匹林（79．36±14．61）％；SA组血小板抑制率：氯吡格雷（74．65±16．24）％，阿司匹林（84．71±11．44）％。UA组的阿司匹林及氯吡格雷的血小板抑制率均低于SA组（P〈0．05）。结论：PCI术围手术期，UA患者对阿司匹林及氯吡格雷的抗血小板效应低于SA患者。

The antiplatelet responsiveness to patients with unstable and stable angina treated with aspirin and clopidogrel after percutaneous coronary intervention

Objective：To observe the antiplatelet responsiveness to patients with unstable angina （UA）and sta- ble angina （SA）for coronary artery disease （CAD） treated with both aspirin and clopidogrel after percutaneous coronary intervention （PCI）.Metbods：We enrolled selective patients with UA and SA after coronary stenting from March to June 2013 in Beijing Shi Jing Shan Hospital.A total of 103 patients of CAD were included,58 patients in UA group,45 patients in SA group.There was no significant difference in diabetes mellitus and the number of stents.All patients were given oral clopidogrel 300mg and aspirin 300mg loading dose the day be- fore PCI and continuously given clopidogrel 75mg/d and aspirin 100mg/d after PCI.The platelet inhibition ratio was measured by thromboelastograph（TEG）24 hours after PCI.Results：In UA group,the platelet inhibition ratio of clopidogrel was（66.41±17.24）% and aspirin was（79.36±14.61）%in SA group,the platelet inhibition ratio of clopidogrel was （74.65±16.24）% and aspirin was （84.71±11.44）%.The platelet inhibition ratio of aspirin and clopidogrel in UA group were both lower than that in SA group（P〈0.05）.Conclusion：Treated with both aspirin and clopidogrel after PCI ,the antiplatelet effeetion to UA patients are worse than SA patients.