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目的:探讨在血栓弹力图监测血小板抑制率的情况下,调整氯吡格雷及阿司匹林用量,治疗冠心病、PCI术后支架内再发血栓患者的临床意义。方法:报告中国人民解放军总医院1例支架内亚急性血栓患者的临床资料并复习相关文献,对其临床表现、诊断、在血栓弹力图指导下的治疗进行分析。结果:1例支架内亚急性血栓患者经治疗病情好转出院,出院后继续调整氯吡格雷及阿司匹林用量,达到满意血小板抑制率,患者症状消失。结论:冠状动脉介入治疗后发生支架内血栓的患者,应用血栓弹力图指导氯吡格雷及阿司匹林用量,可达到令人满意的血小板抑制率,并防止出血情况发生。
Objective: To investigate the clinical significance of adjusting the dosage of clopidogrel and aspirin in the treatment of coronary heart disease and stent thrombosis after stent thrombosis with thromboelastography monitoring of platelet inhibition rate. Methods: The clinical data of one case of subacute thrombosis in Chinese PLA General Hospital were reviewed and the related literatures were reviewed. The clinical manifestations, diagnosis and treatment under the guidance of thromboelastography were analyzed. Results: One case of subacute thrombosis in the stent was discharged after hospitalization. After discharge from the hospital, the dosage of clopidogrel and aspirin continued to be adjusted to achieve satisfactory platelet inhibition rate and the symptoms disappeared. CONCLUSIONS: Patients undergoing stent thrombosis after PCI have a satisfactory thrombocytopenic inhibition rate and prevented bleeding due to the use of thrombelastography to guide the use of clopidogrel and aspirin.