血栓弹力图法和光密度比浊法对双联抗血小板治疗患者的血小板聚集率检测的比较
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国家自然科学基金面上项目(No.30971259; No.30570736/C03030201);解放军总医院科技创新苗圃基金”(09KMM23)


Thromboelastography vs light transmission aggregometry for platelet aggregation in acute coronary syndrome patients under dual antiplatelet therapy
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    摘要:

    目的 分析血栓弹力图法(TEG法)和光密度比浊法(LTA法)对经双联抗血小板治疗的急性冠脉综合征(ACS)患者的血小板聚集率检测的相关性。方法 募集2010年9月至2012年9月,在解放军总医院住院期间行氯吡格雷和阿司匹林双联抗血小板治疗的ACS患者共93名。在患者经口服双联抗血小板药物稳定剂量后取血,分别采用LTA法和TEG法,检测腺苷二磷酸(ADP)和花生四烯酸(AA)诱导的血小板聚集率,并对不同方法的检测指标进行相关回归分析。结果 在93名ACS受试者中,应用LTA法和TEG法检测的ADP诱导的血小板聚集率分别为(59.3±21.34)%和(63.67±28.15)%,两者之间的相关系数为0.814(P<0.0001),回归方程为^Y(比浊法)=0.2+0.617X血栓弹力图法。LTA法和TGA法检测的AA诱导的血小板聚集率分别为(40.87±35.16)%和(46.02±39.26)%,两者的相关系数为0.965(P<0.0001),回归方程为^Y(比浊法)=1.077 X血栓弹力图法+0.02。结论 在双联抗血小板治疗的ACS患者中,采用TEG法和LTA法检测的血小板功能具有较好的一致性。

    Abstract:

    Objective To analyze the correlation between the platelet aggregation from thromboelastography (TEG) and light transmission aggregation (LTA) in patients with acute coronary syndrome (ACS) after dual antiplatelet therapy. Methods Ninty-three ACS patients who were prescribed with aspirin and clopidogrel in Institute of Geriatric Cardiology, Chinese PLA General Hospital during September 2010 to September 2012 were subjected in this study. They received LTA and TEG to determine platelet aggregation induced by adenosine diphosphate (ADP) and arachidonic acid (AA). Correlation and regression analysis were applied to analyze the relationship between detection indicators. Results The ADP-induced platelet aggregation were (59.3±21.34)% and (63.67±28.15)% respectively by LTA and TEG, with a correlation coefficient r=0.814 (P<0.0001), and the regression equation was ^YLTA=0.2+0.617XTEG. The AA-induced platelet aggregation were (40.87±35.16)% and (46.02±39.26)% respectively with LTA and TEG with a correlation coefficient r=0.965(P<0.0001), and the regression equation was ^YLTA=1.077XTEG+0.02. Conclusion Platelet function determined by LTA and TEG is in good correlation in ACS patients after dual antiplatelet therapy.

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张蓝宁, 白 洁, 李玉茹, 杨 洁, 徐 斌, 王红娟, 张玉霄, 卢才义*,尹 彤*.血栓弹力图法和光密度比浊法对双联抗血小板治疗患者的血小板聚集率检测的比较[J].中华老年多器官疾病杂志,2013,12(01):25~28

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