| ObjectiveTo analyze the correlation between the blood stasis of acute coronary syndrome and the indexes of thrombelastogram through clinical observation; and assess the drug responses in different patients after taking aspirin and clopidogrel, in order to find appropriate TCM treatment methods for patients with acute coronary syndrome underwent intervention operation and provide reference for the clinical treatment.Method121 patients with acute coronary syndrome underwent intervention operation and accepted combined anti-platelet treatment with aspirin and clopidogrel in Dongzhimen Hospital of Beijing University of Chinese Medicine from January,2014 to January,2015 were involved in this study. General materials of the patients were collected, and the information of patients’associated symptoms were collected according to Quantitative diagnosis standards of blood stasis syndromes>, and the patients’blood stasis syndromes were graded, the patients’syndromes were differentiated according to<The TCM syndrome differentiation standard of coronary heart disease> and confirmed by a cardiologist with associate professor title or higher level title.24h after the combined anti-platelet treatment, patients’venous blood was tested, and the indexes were R value, K value, Angle, MAThrombin, MAFibnn, MAAA, MAADP of the thrombelastogram and PLT, PT, APTT, TT, FIB of the physicochemical indexes. Finally, the collected data was analyzed by SPSS 17.0.Result1.Among the patients with acute coronary syndrome underwent intervention operation whose age was at 50-70 years,45-59 years and 60-69 years, there were much more males than females(P<0.05); while among patients whose age was 70-75 years, females were more than males(P<0.05). In addition, for smoking patients, males were more than females(P<0.05). For type A character patients, males were much more than females; for type B character patients, females were much more than males(P<0.05).2. Quantitative grading of blood stasis was conducted on 121 patients, with lowest score of 13, highest score of 59, average score of 34.13±12.32, among which 3 cases were not blood stasis syndrome,83 cases were slight blood stasis syndrome and 35 cases were severe blood stasis syndrome.3.118 cases were determined as blood stasis according to the quantitative grading of blood stasis,116 cases were determined as blood stasis according to syndrome factors, among which the grading level of 84 cases was slight(72.4%), the grading level of the remaining 32 cases was severe(26.4%).4. The observation of the combined information of blood stasis and other syndromes indicated that the most common accompanied syndrome with blood stasis was Qi deficiency syndrome(40.5%), following by phlegm syndrome(34.7%), while the largest slight/severe ratio was Qi deficiency syndrome(3.45:1), following by phlegm syndrome(2.5:1).5. Comparing with those patients without blood stasis, patients with blood stasis had a smaller R value and K value, while the Angle, MAThrombin, MAFibrin were increased, indicating that the blood was in hypercoagulable state, the platelet activity was increased, and the difference had statistical significance(P< 0.05).6. Comparing with patients with slight blood stasis, patients with severe blood stasis had a smaller R value, K value, but the value of Angle, MAThrombin and MAFibrin increased significantly, indicating that the blood was in hypercoagulable state, the platelet activity was increased, and the difference had statistical significance(P<0.05). And the MAADP value in patients with severe blood stasis was larger than 47mm.7.68 patients presented low response to clopidogrel,38 patients presented low response to aspirin,28 patients presented resistance to both aspirin and clopidogrel.8. Patients without blood stasis didn’t shown low response to anti-platelet drugs. Blood stasis had a close relationship with clopidogrel(P<0.05).Conclusion1. Patients with acute coronary syndrome mainly focus on 50-70 years, and males are more than females.2. Blood stasis is the major syndrome type of patients with acute coronary syndrome.3. Blood stasis has a certain degree of correlation with coagulation function and platelet activity.4. The effect of anti-platelet treatment varies from case to case, some of the patients presented low response to anti-platelet drugs, thus the drug dose or treatment plan should be revised.5. Patients with severe blood stasis and presented low response to clopidogrel have a higher risk of thrombus after the intervention operation.6. For patients presented low response to anti-platelet drugs, combined treatment plan of promoting circulation and removing stasis method and anti-platelet treatment should be considered.7. Thrombelastogram has a certain degree of application value to the monitoring after intervention operation.
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