• 中国科学论文统计源期刊
  • 中国科技核心期刊
  • 美国化学文摘(CA)来源期刊
  • 日本科学技术振兴机构数据库(JST)
临床输血与检验

临床输血与检验 ›› 2017, Vol. 19 ›› Issue (1): 59-63.DOI: 10.3969/j.issn.1671-2587.2017.01.017

• 临床检验 • 上一篇    下一篇

血栓弹力图法和光学比浊法监测PCI术后氯吡格雷疗效的对比研究*

李广华, 李阳华, 范小斌, 谢年谨, 李正康, 刘长钰, 古俊兰   

  1. 510080 广州,广东省人民医院/广东省医学科学院检验科（李广华,范小斌,李正康,刘长钰,古俊兰）;
    深圳市光明新区人民医院心血管内科（李阳华）; 心内科（谢年谨）
  • 收稿日期:2016-09-30 出版日期:2017-02-20 发布日期:2017-03-02
  • 作者简介:李广华（1974-）,男,广东梅州人,副主任技师,硕士,主要从事血栓止血工作,（Tel）13925119975。
  • 基金资助:
    *本课题受广东省医学科研基金（No; A2015442）资助

Comparatively Study on the Thromboelastography and Light Transmission Aggregometry for Platelet Aggregation in Acute Coronary Syndrome Patients after Percutaneous Coronary Intervention under Antiplatelet Therapy

LI Guang-hua, LI Yang-hua, FAN Xiao-bin, et al   

  1. Department of Clinical Laboratory,Guangdong General Hospital,Academy of Medical Sciences,Guangzhou,510080
  • Received:2016-09-30 Online:2017-02-20 Published:2017-03-02

PDF

693

摘要： 目的 探讨光学比浊法（LTA）和血栓弹力图法（TEG）检测氯吡格雷抵抗（CPGR）的疗效。方法 收集2015年1~11月心内科经双联抗血小板治疗并行冠状动脉介入（PCI）后的急性冠状动脉综合征（ACS）患者425例,对ADP诱导的光学比浊法血小板聚集率（LTAADP）与血栓弹力图法ADP诱导的血小板抑制率（TEGADP）检测氯吡格雷抵抗（CPGR）进行一致性和相关性分析,结合CYP2C19基因表达的酶活性程度,分析其与LTA和TEG法检测CPGR的关系。结果 LTA和TEG法所测血小板聚集率检测CPGR分别为12.0%和11.8%,两者存在负相关（r=-0.351,P<0.01）;CYP2C19基因酶活性程度与LTA法检测CPGR存在一定的等级相关（r=0.239,P<0.01）,与TEG法检测CPGR的关联无统计学意义（r=-0.088,P=0.70）,且在两法检测CPGR上的差异无统计学意义。结论 TGE与LTA法在监测氯吡格雷疗效上有很好的一致性,CYP2C19基因酶活性程度与这两种方法检测CPGR的差异无统计学意义。

关键词: 氯吡格雷抵抗, 双联抗血小板, 血栓弹力图, 光学比浊法CYP2C19基因

Abstract: Objective The dual antiplatelet drug for the treatment of percutaneous coronary intervention after operation of acute coronary syndrome patients,the by optical than Light Transmission Aggregometry （LTA） and Method of thromboelastography（TEG） detection of clopidogrel resistance（CPGR） consistency analysis,and compare the correlation with the levels of CYP2C19 enzyme activity. Methods A total of 425 patients with acute coronary syndrome treated with dual antiplatelet therapy and PCI in the Department of Cardiology during the period of January 2015 to November were collected. Consistency and correlation analysis of CPGR induced platelet aggregation rate （LTAADP） and ADP induced platelet inhibition rate （TEGADP） as well as the relationship between the two Methods to detect CPGR and CYP2C19 gene expression level were done. Results The platelet aggregation rate measured by the LTA Method was used to detect the CPGR as 12%. The platelet inhibition rate measured by the TEG Method was used to detect the CPGR as 11.8%. There is a negative correlation between LTAADP and TEGADP （r=-0.351,P<0.01）; There was a certain degree of correlation between the activity of CYP2C19 gene and the detection of CPGR by LTA Method （r=0.239,P=0.00）. No correlation between the degree of activity of CYP2C19 gene and the detection of CPGR by TEG Method （r=-0.088,P=0.70）. And no significant difference between the two Methods in the detection of CPGR was found. Conclusion TGE Method and LTA Method to monitor the efficacy of clopidogrel has well consistency,There was no significant difference between the two Methods for the detection of CPGR with the degree of CYP2C19 gene activity.

Key words: Clopidogrel resistance, Dual antiplatelet, Thromboelastography, Light transmission aggregometry CYP2C19

中图分类号: