血栓弹力图在糖尿病肾病维持性血液透析患者抗血小板药物反应性中的评估价值

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Abstract Objective To explore the value of thromboelastography (TEG) in evaluating the effect of antiplatelet drugs after percutaneous coronary intervention (PCI) in patients with diabetic nephropathy (DN) maintenance hemodialysis. Methods A total of 46 patients with maintenance hemodialysis who were treated at the People′s Hospital of Zhejiang Province from May 2013 to March 2016 and received aspirin combined with clopidogrel within 1 year after PCI were included. According to whether end-stage renal disease caused by DN started maintenance hemodialysis, all patients were divided into DN group (20 cases) and NDN group (26 cases), and TEG test was performed. The maximum thrombus (MA), arachidonic acid (AA) pathway inhibition rate, and adenosine diphosphate (ADP) receptor inhibition rate were used to evaluate drug resistance and analyze clinical significance. Results The MA value in DN group was higher than that in group B, and the difference was statistically significant (P ＜ 0.05). The resistance rate of double platelet aggregation in DN group was higher than that in NDN group, and the difference was statistically significant (P ＜ 0.05). There were no significant differences in the aspirin resistance rate and clopidogrel resistance rate between the two groups of patients (P ＜ 0.05). Conclusion Patients with DN have a higher risk of thrombosis after PCI compared with NDN patient. Both DN and NDN patients have resistance to dual antiplatelet drugs, and patients with DN are very resistant, suggesting that platelet function to guide the adjustment of the drug may be required in such high-risk patients.

Key words： Diabetic kidney disease Hemodialysis Thrombelastography Antiplatelet therapy

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	JIN Qinyang1 ZHU Qin2 YE Xianyun3 GUAN Binya4

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JIN Qinyang1 ZHU Qin2 YE Xianyun3 GUAN Binya4. The value of thromboelastography for the antiplatelet drug reactivity in patients with diabetic nephropathy undergoing maintenance hemodialysis[J]. 中国医药导报, 2020, 17(4): 94-97.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2020/V17/I4/94

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