Analysis Of Thrombelastogram Monitoring’s Effect Of Guilding Antiplatelet Therapy And Observing The Ischemia Event In Patients With PCI After Operation

ObjectiveReview the treatment application of Thrombelastogram monitoring anti platelet analysisin89cases of PCI patients with postoperative results, analysis the characteristics ofcoagulation in patients with different types of coronary heart disease, related factors ofoccurrence of ischemic events and analysis of PCI patients after operation, to explore theThrombelastogram on antiplatelet therapy in patients with PCI effect after operation.METHODSThe review period of2013October to2014September analysis, at the Jilin University inChina Japan Union Hospital Department of Cardiology for treatment of PCI, and the use ofthromboelastography in postoperative map antiplatelet efficacy monitoring in patients withcoronary heart disease in89cases. According to the characteristics of disease is divided intoacute myocardial infarction group (AMI group),31patients with unstable angina pectoris(UAP group) and44cases of stable angina pectoris group (AP group)14cases. Acomparative analysis among the groups of thromboelastography and coagulation ofconventional indicators, and all patients were divided into groups according to the differenceof antiplatelet drug reaction monitoring of thromboelastography results (group A) andantiplatelet drug response in normal group (group B). Comparative analysis of causes ofpoor response to antiplatelet drugs, and all patients were followed up, according to therelated factors of outcomes of patients with coronary artery disease after PCI of ischemicevents.RESULTS1. AMI group and UAP group of patients with thromboelastography R value, K valuewas significantly lower than that of AP group (P <0.05), and the value of MA and Angelwere significantly higher than that of AP group (P <0.05).2. AMI, UAP, AP three groups of high coagulation appeared significant differencebetween the proportion of group (P <0.05), AMI group＞UAP group＞AP group.3. AMI group and UAP group of serum fibrinogen (Fgb), and two D-D dimer (D-D)were significantly higher than those in AP group (P <0.05). 4. Activated partial thromboplastin time in group AMI (APTT) and internationalnormalized ratio (INR) was significantly higher than that in UAP group and AP group (P <0.05), fibrin, AMI group and UAP group (Fgb), and the original two D-D dimer (D-D) weresignificantly higher than those in AP group (P <0.05).5. History of diabetes and smoking may be the cause of the anti platelet drug reactionswere independent risk factors of low.6. The level of Fgb, aspirin and clopidogrel induced platelet aggregation induced byinhibition of platelet aggregation inhibition, three may be the cause of the anti platelet drugreactions were independent risk factors of low.CONCLUSION:1. AMI and UAP in patients with high blood coagulation state, was significantly higherthan that in patients with AP, and accompanied by secondary fibrinolysis.Thromboelastography can be used in diagnosis of coronary heart disease, detection ofdisease development, anticoagulation indexes.2. Smoking is a risk factor for AMI, and the effect on antiplatelet effect of ClopidogrelHydrogen patients after PCI.3. The high level of Fgb and patients may increase the probability of occurrence ofischemic events in patients with low response to clopidogrel, platelet aggregation byThrombelastogram detection of fibrinolytic inhibition rate can guide the clinical treatmenteffect, reduce the incidence of ischemic events.4. Thromboelastography in percutaneous coronary intervention in patients withantiplatelet therapy has certain application value in monitoring.