金钦阳 朱勤 叶羡云

    [摘要] 目的 探讨血栓弹力图(TEG)在糖尿病肾病(DN)维持性血透患者行经皮冠状动脉介入治疗(PCI)后抗血小板药物效果的评估价值。 方法 纳入2013年5月～2016年3月于浙江省人民医院就诊，行PCI术后1年内接受阿司匹林联合氯吡格雷双抗治疗的维持性血透患者46例。按照是否为DN所致终末期肾病而开始维持性血透分为DN组(20例)及NDN组(26例)，进行TEG检测。血栓最大幅度(MA)、花生四烯酸(AA)途径抑制率、二磷酸腺苷(ADP)受体抑制率评估药物抵抗及分析临床意义。 结果 DN组MA值高于NDN组，差异有统计学意义(P 0.05)。 结论 与NDN患者比较，DN患者具有更高的PCI术后血栓风险。DN及NDN患者均存在对双联抗血小板药物抵抗，DN患者为甚，提示在此类高危患者可能需要常规进行血小板功能检测以指导调整药物。

    [关键词] 糖尿病肾病;血透;血栓弹力图;抗血小板治疗

    [中图分类号] R459.5? ? ? ? ? [文献标识码] A? ? ? ? ? [文章编号] 1673-7210(2020)02(a)-0094-04

    [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 ......