冠心病患者静息心率与血小板活性相关研究

目的:探讨冠心病患者静息心率与血小板活性的相关研究。方法:选择2013年1月至2014年9月于我院住院患者474例,按静息心率快慢分为三组,心率70 bmp为第一组(Q1)150例,心率位于70~85 bmp为第二组(Q2)265例,心率85 bmp为第三组(Q3)59例,三组患者均于病情稳定时行血栓弹力图(TEG)中MA值检测,同时随访3个月,观察和比较三组患者MA值变化及预后。结果:三组患者MA值分别为61.16±7.29 mm、62.02±7.46 mm、65.32±6.56 mm,第三组患者MA值与第一组或第二组患者MA值比较差异均存在统计学意义(P0.05),通过血栓弹力图检测三组经花生四烯酸(AA)途径的血小板抑制率和经二磷酸腺苷(ADP)途径的血小板抑制率发现,静息心率高低与抗血小板药物作用疗效无相关关系(P0.05)。随访3个月,三组患者心绞痛、再住院、脑血管病及死亡的总发生率分别为28%、28.68%、40.67%。结论:冠心病患者静息心率越快,MA值越大即血小板活性越高,静息心率的高低与抗血小板药物作用疗效无关。

Related Research of Resting Heart Rate and Platelet Activity in Patients with Coronary Heart Disease

Objective:To analyze the relationship between resting heart rate and platelet activity in patients with coronary heart disease.Methods:474 cases of patients with coronary heart disease admitted in our hospital from January 2013 to September 2014 were selected for this study. There were 150 cases of patients'' resting heart rate lower than 70 bmp (Q1 group), and 265 cases of patients'' resting heart rate between 70 bmp and 85 bmp (Q2 group), and 59 higher than 85bmp (Q2 group). All the patients were detected MA value in thrombelastography (TEG), and followed up for 3 months. The MA value and prognosis were compared among three groups.Results:The MA value of three groups were 61.16± 7.29 mm, 62.02± 7.46 mm, 65.32± 6.56 mm. There were significant differences between Q1 and Q3, and between Q2 and Q3 (P<0.05). Through ADP and AA pathway, the effect of antiplatelet agents were observed and compared among the three groups, the results showed that resting heart rate was not related with the effect of antiplatelet agents. After 3 months, follow-up, the total incidence of adverse events including angina, rehospitalization, cerebrovascular disease and death were 28 %, 28.68 %, and 40.67 % in the three groups, respectively.Conclusion:The patients of coronary heart disease with the faster resting heart rate had the greater MA value, which meant the higher platelet activity, and the level of resting heart rate was not related with the effect of antiplatelet agents.