Value research on thromboelastogram(TEG) in the monitoring of platelet activity variation tendency of PCI surgery patients

摘要

Objective:To discuss the value research on thromboelastogram (TEG) in the monitoring of platelet activity variation tendency of PCI surgery patients.Method:180 cases of patients with coronary heart disease who have proceeded PCI surgery were selected and divided into AMI group, UAP group and AP group. To compare the coagulation indicator, TEG and pathological changes of these three groups; all patients were adopted conventional therapy, after operation, divided them into anti-platelet low reaction group (platelet high reaction group) and normal group according to platelet aggregation rate monitored by TEG, and compared the clotting all items, clinical indicator, PCI postoperative platelet aggregation inhibition rate and clinical ischemia cases occurrence rate within 6 months follow up visit of both groups.Results: TEG parametric R value and K value in AMI group and UAP group were obviously lower than that in AP group, MA value and angle value were obviously higher than AP group, significant difference; TEG image in AMI group and UAP group mainly featured hypercoagulability, while TEG image had no hypercoagulability in AP group; Chi-square test showed that hypercoagulability image percentage differences between these three groups had statistical significance; ADP and AA induced platelet inhibition rate determined by TEG in high reaction group was obviously lower than that in normal group; 6 cases in platelet high reaction group: CK-MB rose and exceeded normal value upper limit (10.90%), 9 cases: cTnI rose and exceeded normal value upper limit (19.6%), compared with normal group (3 cases, 2.4%; 5 cases, 4%), the value in platelet high reaction group was higher, and the difference was significant; platelet high reaction group: totally 10 cases of ischemia, occurrence rate was 10.5%, while platelet normal reaction group: totally 3 cases (2.4%), chi-square test showed that the difference between these two groups had statistical significance.Conclusion:Thromboelastogram (TEG), in monitoring the PCI preoperative and postoperative platelet activity of patients, had guiding value to antiplatelet therapeutic regimens of PCI surgery patients.