| Objective:To explore the effect of hemodialysis on the antiplatelet aggregation of aspirin and clopidogrel,as well as the platelet reactivity of hemodialysis patients,and provide guidance for the antiplatelet therapy of hemodialysis patients after PCI.Methods:23 cases patients with chronic kidney disease on maintenance hemodialysis and coronary heart disease from January to October 2020 were collected.All patients were treated with aspirin and clopidogrel to detect and analyze the platelet aggregation rate before and after hemodialysis.According to whether the platelet aggregation rate after adenosine diphosphate(ADP)induction is >55%,it is divided into high on-treatment platelet reactivity group(HPR)and low on-treatment platelet reactivity group(LPR)after clopidogrel treatment.Analysis of risk factors that lead to high on-treatment platelet reactivity.Simultaneously compare the incidence of adverse cardiovascular events(MACE)between the two groups at 6 months.Results:The platelet aggregation rates of arachidonic acid-induced before and after hemodialysis were 7.7 ± 6.9% and 13.2 ± 8.6%.The platelet aggregation rates of adenosine diphosphate-induced before and after hemodialysis were32.0 ± 17.2% and40.6±19.0%.The difference were statistically significant.And before dialysis,6 patients(26.1%)showed high on-treatment platelet reactivity,while after dialysis,9 patients(39.1%)showed high on-treatment platelet reactivity.Hyperlipidemia and increased glomerular filtration rate are related to HPR,which is statistically significant.The incidence of MACE in the HPR group(22.2%)was evidently higher than that in the LPR group(7.1%),but the difference was not statistically significant(p >0.05).Conclusion:The platelet aggregation rate of patients after hemodialysis is increased,showing a high incidence of HPR,resulting in a decrease in the anti-platelet aggregation efficacy of aspirin and clopidogrel.Hyperlipidemia and increased glomerular filtration rate are related to the occurrence of HPR.Among HD patients,the incidence of MACE in HPR patients was significantly higher than that in LPR patients,but it was not statistically significant. |
