不稳定型心绞痛患者血小板计数对低分子肝素抗凝有效性的影响

目的:通过检测抗Xa因子活性,探讨不稳定型心绞痛患者血小板计数(PLT)对低分子肝素抗凝有效性的影响。方法:入选不稳定型心绞痛患者63例,分为两组,A组(n=24):PLT≥240×109/L,B组(n=39):PLT240×109/L。首先比较两组患者之间一般情况有无差异,而后在两组患者皮下注射那曲肝素前及注射后8 h两个时间点分别进行抗Xa因子活性检测并记录结果,分析两组患者抗Xa因子活性水平并比较活性低于0.5 IU·mL-1患者所占比例。结果:两组患者之间一般情况无显著性差异,抗Xa因子活性治疗前后差异在两组中均有统计学意义,A组治疗后抗Xa因子活性均值低于B组,抗Xa因子0.5 IU·mL-1的患者比率高于B组,组间比较差异显著。结论:在低分子肝素抗凝治疗中,血小板计数≥240×109/L的患者抗Xa因子活性较低,提示不稳定型心绞痛患者在应用低分子肝素后的抗凝力度不足与血小板计数偏高相关。

The Effects of PLT in Unstable Angina (UA) Patients on Anticoagulation Effectiveness of Low Molecular Weight Heparin(LMWH)

Objective:By detecting the activity of anti-Xa factor to explore the effects of PLT in unstable angina pectoris patients on anticoagulation effectiveness of LMWH. Methods:All 63 ACS patients were divided by into two groups, PLT is higher than 240× 109 /L in group A, and PLT is lesser than 240× 109 /L in group B. Firstly compare the general situations. Then give both two groups a subcutaneous injection of Nadroparin, detect the activity of anti-Xa factors at two time points: before injected and 8h after injected. Analyses the activity levels, and calculate the ratios of patients with anti-Xa factor activity lower than 0.5 IU·mL-1.Results:There is no significant differences between two groups in general situations before treatment. The changes of anti-Xa factor activity after treating in two groups are statistical significance. After treatment, mean of anti-Xa factor activity in group A lower than group B, the ratio of patients which anti-Xa factor activity < 0.5 IU·mL-1 (41.7 %) is higher than group B.Group comparison has significantly differences.(x2=6.99, P<0.01).Conclusion:In the anticoagulant therapy of LMWH, the patients whose PLT over 240× 109 /L are more likely suffered with lower anti-Xa factor activity. It means that a higher PLT level is related to the insufficiency of LMHT anticoagulant after treatment in UA patients.