摘要
目的采用血栓弹力图分析仪（thrombelastography，TEG）和光电比浊法血小板聚集分析仪（light transmission ag-gregometry，LTA）检测氯吡格雷抗血小板功能并分析两种方法的优缺点。方法①用随机数字表法选取2011年3～7月在解放军总医院住院及门诊的急性冠状动脉综合征（acute coronary syndrome，ACS）患者48例（包括不稳定型心绞痛、ST段抬高型心肌梗死、非ST段抬高型心肌梗死患者）。男性32例，女性16例，年龄73岁（62～90）岁。②患者入院时均先顿服阿司匹林160mg和氯吡格雷300mg，之后用氯吡格雷75mg／d的维持量治疗9个月后，在某次服药后2h抽取静脉血。③同时进行LTA和TEG检测，分别得到服药后的二磷酸腺苷（adenosine diphosphate，ADP）诱导的血小板聚集率（用AD-PLTA-INDU表示）、血小板聚集抑制率（用ADPTEG-INHI表示）。所有志恳者均签署了知情同意，该研究获得医院伦理委员会批准。结果48例观察对象均进入结果分析，ADPLTA-INDU值，41例分布在40％～80％（85．4％），7例〉80％（14．6％），CV值：0．19；ADPTEG-INHI值，40例分布在10％～60％（83．3％），2例〈10％（4．2％），6例〉60％（12．5％），CV值：0．54；48例观察对象的（ADPLTA-INDu＋ADPTEG-INHI）趋向一个常数（Mean=98％，SD=12．1），各值与Mean做成组数据配对t检验（P双尾〉0．05）。ADPLTA-INDU值和ADPTEG-INHI值呈负相关（r=一0．75，P〈0．01）。结论氯吡格雷抗血小板功能较温和，且两种方法存在同一性效用，但TEG精密度较低。
Objective To detect the antiplatelet function of clopidogel by Thrombelastography （TEG） and light transmmi- tance aggregometry （LTA） and analyze efficiency of two methods. Methods ①Venous blood samples were taken from 48 outparients and inpatient with acute corotary syndrome （ACS） in PLA General Hospital,including unstable anqina, ST seg- ment elevation myocardial infarction and non ST segment elevation myocardial infarction （32 males, 16 females） by random number table from March to July 2011 ,whose average age was 73 （62～90）. ②All of them were served 160 mg aspirin and 300 mg clopidogrel after they were in hospital at first time,and then served with 75 mg/d clopidogrel for 9 months. After that,venous blood samples were drew from them who were served clopidogrel 2 hours later. （3）Platelet aggregation function was assayed with LTA and TEG. All volunteers were signed informed consent and the experiment was approved by the hos- pital ethics committee. Results The platelet aggregation rate detected with LTA induced by adenosine diphosphate （ADPL- TA-INDU） was 40～80% in 41 individuals （85.4%） ,〉80% in 7 individuals （14.6%） ,coefficient of variation （CV） was 0. 19. The inhibition ration of platelet function （INHI） detected with TEG （ADPTEG-INHD was 10～60% in 40 individu- als （83.3%） ,〈10% in 2 individuals （4.2%） ,〉60 in 6 individuals （12.5%） ,CV was 0.54. The sum of ADPLTA-INDU and ADPTEG-INHI （ADPLTA-INDU＋ADPTEG-INHI） tended to a constant （Mean= 98%, SD= 12.1）. There was no significant indifference between every （ADPLTA-INDU ＋ ADPTEG-INHI） and their Mean （98%） by paired t-test. The ADPLTA-INDU was negative correlated with ADPTEG-INHI （r= -0.75,P〈0.01）. Conclusion The effect of clopidogrel was mild and the efficiency of TEG and LTA was similar in detecting the antiplatelet function of clopidogrel,but the preci- sion of TEG was lower than LTA.
出处
《现代检验医学杂志》
CAS
2014年第6期48-51,共4页
Journal of Modern Laboratory Medicine
