Yang Wu-Xiao, Lai Chun-Lin, Chen Fu-Heng, Wang Ji-Rong, Ji You-Rui, Wang Dong-Xia
Department of Cardiology, People's Hospital of Shaanxi Province, Taiyuan, Shaanxi 030012, P.R. China.
Exp Ther Med. 2017 Jun;13(6):2917-2921. doi: 10.3892/etm.2017.4336. Epub 2017 Apr 13.
The value of Sonoclot detection technology to guide the clinical medication of the perioperative anticoagulation and antiplatelet therapy in patients with acute myocardial infarction (AMI) undergoing emergent percutaneous coronary intervention (PCI) was estimated. One hundred and twenty-eight patients were randomly divided into control group and observation group with 64 cases in each group. Control group adopted routine blood coagulation indexes, including prothrombin time, activated partial thromboplastin time, fibrinogen and plasma thrombin time, platelet count and platelet aggregation turbidity analysis; observation group adopted Sonoclot detection technology, including activated clotting time, coagulation rate and platelet function. Anticoagulant therapy selected was of low molecular weight heparin calcium perioperatively, intraoperative unfractionated heparin, and clopidogrel (75 mg) combined with aspirin enteric-coated tablets (100 mg) as antiplatelet drugs. The therapy was administered in accordance with blood coagulation results. The blood coagulation time, postoperative creatine kinase isoenzyme MB, cardiac troponin I and B-type natriuretic peptide levels in the observation group are significantly lower than those in the control group (P<0.05) though the operating time and specifications of the stenting did not show any significant difference (P>0.05). The incidence of recurrent myocardial infarction, microembolism, acute and subacute thrombosis and bleeding events in the observation group are significantly lower than those in the control group (P<0.05). In the control group, there is no difference in the coagulation indexes of the patients with thrombosis events or bleeding events or no event (P>0.05). Whereas, in the observation group, there is significant difference in coagulation indexes of the patients with thrombosis events or bleeding events or no event (P<0.05). In conclusion, Sonoclot detection technology instructs emergent PCI treatment in AMI patients to shorten the detection time of blood coagulation, reduce the degree of myocardial injury, reduce the incidence of perioperative thrombosis and bleeding events. Furthermore, it has great value in guiding the clinical medication of anticoagulation and antiplatelet therapy.
评估Sonoclot检测技术在指导急性心肌梗死(AMI)患者行急诊经皮冠状动脉介入治疗(PCI)围手术期抗凝和抗血小板治疗临床用药中的价值。将128例患者随机分为对照组和观察组,每组64例。对照组采用常规凝血指标,包括凝血酶原时间、活化部分凝血活酶时间、纤维蛋白原、血浆凝血酶时间、血小板计数及血小板聚集浊度分析;观察组采用Sonoclot检测技术,包括活化凝血时间、凝血速率及血小板功能。围手术期抗凝治疗选用低分子肝素钙,术中使用普通肝素,抗血小板药物选用氯吡格雷(75mg)联合阿司匹林肠溶片(100mg)。根据凝血结果调整治疗方案。观察组凝血时间、术后肌酸激酶同工酶MB、心肌肌钙蛋白I及B型利钠肽水平均显著低于对照组(P<0.05),而手术时间及支架植入规格差异无统计学意义(P>0.05)。观察组心肌梗死复发、微栓塞、急性及亚急性血栓形成和出血事件发生率均显著低于对照组(P<0.05)。对照组发生血栓事件、出血事件及未发生事件患者的凝血指标差异无统计学意义(P>0.05);而观察组发生血栓事件、出血事件及未发生事件患者的凝血指标差异有统计学意义(P<0.05)。综上所述,Sonoclot检测技术指导AMI患者急诊PCI治疗可缩短凝血检测时间,减轻心肌损伤程度,降低围手术期血栓形成和出血事件发生率,在指导抗凝和抗血小板治疗临床用药方面具有重要价值。