| 李小林,罗裕,柳永华,刘中文,范成辉,欧军萍.P2Y12反应性和血小板抑制率在预测ACS患者PCI术后长期预后中的作用[J].井冈山大学自然版,2021,42(3):96-101 |
| P2Y12反应性和血小板抑制率在预测ACS患者PCI术后长期预后中的作用 |
| VALUE OF P2Y12 REACTION AND PLATELET INHIBITION IN PREDICTING LONG-TERM CLINICAL OUTCOMES IN PATIENTS WITH ACUTE CORONARY SYNDROME (ACS) UNDERGOING PERCUTANEOUS CORONARY INTERVENTION (PCI) |
| 投稿时间：2020-10-16 修订日期：2020-12-26 |
| DOI：10.3669/j.issn.1674-8085.2021.03.017 |
| 中文关键词: 血小板反应性 氯吡格雷 急性冠状动脉综合征 经皮冠状动脉介入治疗 预后 |
| 英文关键词: platelet reactivity clopidogrel acute coronary syndrome percutaneous coronary intervention prognosis |
| 基金项目:江西省教育厅科学技术项目（GJJ180579）；井冈山大学博士科研启动项目（JZB1820） |
| 作者 | 单位 | | 李小林 | 井冈山大学医学部, 江西, 吉安 343009
上海市东方医院吉安医院心内科, 江西, 吉安 343000 | | 罗裕 | 同济大学附属上海市东方医院心内科, 上海 200120 | | 柳永华 | 保山市人民医院心脏科, 云南, 保山 678000 | | 刘中文 | 上海市东方医院吉安医院心内科, 江西, 吉安 343000 | | 范成辉 | 同济大学附属上海市东方医院心内科, 上海 200120 | | 欧军萍 | 上海市东方医院吉安医院心内科, 江西, 吉安 343000 |
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| 中文摘要: |
| 目的 探讨P2Y12反应性和血小板抑制率在ACS患者PCI术后发生心肌缺血事件的价值。方法 采用VerifyNow P2Y12系统检测P2Y12反应性和血小板抑制率，计算ACS患者术后30天COP-INH值。综合分析COP-INH评分与主要终点事件的相关性。结果 在226例受试者中，在排除糖尿病（46.15% vs.21.93%， P=0.015）、既往冠状动脉搭桥术（23.08% vs.7.49%，P=0.008）等混杂因素后，COP-INH 2分、1分或0分三组受试者临床特征无显著差异。结果显示COP-INH=2的患者主要不良心血管事件的发生率明显高于评分为1或0的患者（23.08% vs.5.88%，P=0.007）。多因素分析表明，COP-INH=2是ACS患者PCI术后主要不良心血管事件的独立预测指标（P=0.025），而1或0分者差异并无统计学意义。结论 COP-INH可作为ACS患者PCI治疗术后长期不良心血管事件的一个有意义的预测指标。 |
| 英文摘要: |
| Objective: To investigate the value of P2Y12 reaction and platelet inhibition in predicting the long-term ischaemic events in patients with ACS undergoing PCI. Methods: P2Y12 reaction and platelet inhibition rates were assessed by VerifyNow P2Y12 assay, the COP-INH was calculated according to the data obtained at 30 days after PCI. The relationship between the COP-INH score and primary endpoint was analyzed. Results: 226 patients were enrolled. There were no significant differences in clinical characteristics among the patients with COP-INH=2, 1 or 0, except for the patients with diabetes mellitus (46.15% vs. 21.93%, p=0.015) and previous coronary artery bypass grafting (23.08% vs. 7.49%, p=0.008). The incidence of major adverse cardiovascular events (MACE) in patients with COP-INH=2 was significantly higher than that in patients with COP-INH=1 or 0 (23.08% vs 5.88%, p=0.007). Multivariate analysis showed that the COP-INH=2 was an independent predictor of MACE in patients with ACS undergoing PCI (p=0.025), whereas there were no statistical significance in the differences of the patients with the COP-INH=1 or 0. Conclusion: The COP-INH is considered to be a useful predictor of long-term schaemic events of patients with ACS undergoing PCI. |
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