现代检验医学杂志
現代檢驗醫學雜誌
현대검험의학잡지
JOURNAL OF MODERN LABORATORY MEDICINE
2014年
6期
48-50,51
,共4页
任军伟%张艳萍%丛玉隆%楚杜武
任軍偉%張豔萍%叢玉隆%楚杜武
임군위%장염평%총옥륭%초두무
抗血小板功能%血小板聚集%光电比浊法血小板聚集分析仪%血栓弹力图分析仪%二磷酸腺苷
抗血小闆功能%血小闆聚集%光電比濁法血小闆聚集分析儀%血栓彈力圖分析儀%二燐痠腺苷
항혈소판공능%혈소판취집%광전비탁법혈소판취집분석의%혈전탄력도분석의%이린산선감
antiplatelet function%platelet aggregation%LTA%TEG%ADP
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160 mg和氯吡格雷300 mg,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2 h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)。所有志愿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=-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。
目的:採用血栓彈力圖分析儀(thrombelastography,TEG)和光電比濁法血小闆聚集分析儀(light transmission ag-gregometry,LTA)檢測氯吡格雷抗血小闆功能併分析兩種方法的優缺點。方法①用隨機數字錶法選取2011年3~7月在解放軍總醫院住院及門診的急性冠狀動脈綜閤徵(acute coronary syndrome,ACS)患者48例(包括不穩定型心絞痛、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,年齡73歲(62~90)歲。②患者入院時均先頓服阿司匹林160 mg和氯吡格雷300 mg,之後用氯吡格雷75mg/d的維持量治療9箇月後,在某次服藥後2 h抽取靜脈血。③同時進行 LTA和TEG檢測,分彆得到服藥後的二燐痠腺苷(adenosine diphosphate,ADP)誘導的血小闆聚集率(用AD-PLTA-INDU錶示)、血小闆聚集抑製率(用 ADPTEG-INHI錶示)。所有誌願者均籤署瞭知情同意,該研究穫得醫院倫理委員會批準。結果48例觀察對象均進入結果分析,ADPLTA-INDU值,41例分佈在40%~80%(85.4%),7例>80%(14.6%),CV值:0.19;ADPTEG-INHI值,40例分佈在10%~60%(83.3%),2例<10%(4.2%),6例>60%(12.5%), CV值:0.54;48例觀察對象的(ADPLTA-INDU+ADPTEG-INHI)趨嚮一箇常數(Mean=98%,SD=12.1),各值與 Mean做成組數據配對t檢驗(P雙尾>0.05)。ADPLTA-INDU值和 ADPTEG-INHI值呈負相關(r=-0.75,P<0.01)。結論氯吡格雷抗血小闆功能較溫和,且兩種方法存在同一性效用,但TEG精密度較低。
목적:채용혈전탄력도분석의(thrombelastography,TEG)화광전비탁법혈소판취집분석의(light transmission ag-gregometry,LTA)검측록필격뢰항혈소판공능병분석량충방법적우결점。방법①용수궤수자표법선취2011년3~7월재해방군총의원주원급문진적급성관상동맥종합정(acute coronary syndrome,ACS)환자48례(포괄불은정형심교통、ST단태고형심기경사、비ST단태고형심기경사환자)。남성32례,녀성16례,년령73세(62~90)세。②환자입원시균선돈복아사필림160 mg화록필격뢰300 mg,지후용록필격뢰75mg/d적유지량치료9개월후,재모차복약후2 h추취정맥혈。③동시진행 LTA화TEG검측,분별득도복약후적이린산선감(adenosine diphosphate,ADP)유도적혈소판취집솔(용AD-PLTA-INDU표시)、혈소판취집억제솔(용 ADPTEG-INHI표시)。소유지원자균첨서료지정동의,해연구획득의원윤리위원회비준。결과48례관찰대상균진입결과분석,ADPLTA-INDU치,41례분포재40%~80%(85.4%),7례>80%(14.6%),CV치:0.19;ADPTEG-INHI치,40례분포재10%~60%(83.3%),2례<10%(4.2%),6례>60%(12.5%), CV치:0.54;48례관찰대상적(ADPLTA-INDU+ADPTEG-INHI)추향일개상수(Mean=98%,SD=12.1),각치여 Mean주성조수거배대t검험(P쌍미>0.05)。ADPLTA-INDU치화 ADPTEG-INHI치정부상관(r=-0.75,P<0.01)。결론록필격뢰항혈소판공능교온화,차량충방법존재동일성효용,단TEG정밀도교저。
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.③Platelet 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-INHI)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.