• 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 ›› 2020, Vol. 22 ›› Issue (5): 492-497.DOI: 10.3969/j.issn.1671-2587.2020.05.012

• 临床输血 • 上一篇    下一篇

两种血小板功能检测方法对急性期脑梗死患者氯吡格雷抵抗的诊断效能评价*

郁金凤, 刘德林, 陆乐, 王树亚, 刘婷婷, 李平   

  1. 210008 南京大学医学院附属鼓楼医院(郁金凤,陆乐,王树亚,刘婷婷,李平);
    东南大学附属中大医院内分泌科(刘德林)
  • 收稿日期:2019-06-11 出版日期:2020-10-20 发布日期:2020-10-16
  • 通讯作者: 李平,男,主任医师,硕士,主要从事临床输血与止凝血等研究,(Tel)025-83106666(E-mail)glyysxk@163.com。
  • 作者简介:郁金凤(1986-),女,山东临沂人,住院医师,硕士,主要从事临床输血与细胞治疗等研究,(E-mail)lyxx201707@163.com。
  • 基金资助:
    *本课题受南京市科技计划项目(No.201715018)资助

Two Platelet Function Assays in the Diagnosis of Clopidogrel Resistance in Patients with Acute Cerebral

YU Jin-feng, LIU De-lin, LU Le, et al   

  1. Department of Blood Transfusion, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing 210008
  • Received:2019-06-11 Online:2020-10-20 Published:2020-10-16

摘要: 目的 探讨PFA-200 P2Y法、吸光度比浊法(LTA)对氯吡格雷抵抗(clopidogrel resistance, CR)的诊断效果并进行CR相关影响因素分析。 方法 选取2018年1月~2018年12月于南京鼓楼医院就诊的急性脑梗死患者95例。所有患者氯吡格雷75 mg/d治疗>3天后,采用PFA-200 P2Y法、LTA法检测患者的血小板功能,统计两种方法检测的CR发生率并对检测结果进行相关性分析。根据检测结果将患者分为CR组和N-CR(非氯吡格雷抵抗)组,比较两组患者的临床因素差异,将差异变量进行Logistic回归,分析相关因素与CR发生的关系。 结果 PFA-200 P2Y法检测出CR患者22例(23.2%),LTA法检测出CR患者53例(55.8%)。两种方法比较差异有统计学意义(χ2=21.170,P<0.001)。根据LTA法检测结果将患者分为CR组和N-CR组,单因素分析显示两组患者在血同型半胱氨酸、白细胞计数有差异(χ2=8.589,P=0.004;χ2=5.537,P=0.021);Logistic多因素回归分析显示白细胞计数(OR=1.551,P=0.010)是CR的独立危险因素,同型半胱氨酸(OR=0.916,P=0.037)是CR的独立保护因素。 结论 PFA-200 P2Y、LTA两种方法检测急性脑梗死患者氯吡格雷抵抗一致性较差。同型半胱氨酸是CR的独立保护因素,血白细胞计数升高是发生CR的独立危险因素。

关键词: PFA-200 P2Y LTA, 急性脑梗死, 氯吡格雷抵抗

Abstract: Objective To investigate the diagnostic effect of platelet function analyzer(PFA)-200P2Y and Light transmittance aggregometry(LTA)on clopidogrel resistance(CR)and analyze the relevant factors for CR. Methods Ninety-five patients with acute cerebral infarction were selected from Nanjing Drum Tower Hospital from January 2018 to December 2018. All patients were treated with clopidogrel 75 mg/d for more than 3 days, platelet function was measured by PFA-200P2Y and LTA methods. The incidence of CR detected by the two methods was calculated and the correlation between the results of the two methods was analyzed. The patients were divided into CR group and N-CR(non-clopidogrel resistance)group according to the test results. The differences of clinical factors between the two groups were compared, and the related factors that may influence the occurrence of CR were analyzed by Logistic regression. Results 22(23.2%)CR patients were detected by PFA-200P2Y and 53(55.8%)CR patients were founded by LTA. There was significant difference between the two methods(χ2= 21.170,P<0.001). Univariate analysis showed that there were significant differences in blood homocysteine (χ2=8.589, P=0.004)and white blood cell count(χ2=5.537,P=0.021)between the CR and N-CR groups according to LTA grouping. Logistic regression analysis showed that white blood cell count(OR=1.551,P=0.010)was an independent risk factor for CR, and homocysteine(OR=0.916,P=0.037)was an independent protective factor for CR. Conclusion The consistency between the results of PFA-200P2Y and LTA methods in detecting clopidogrel resistance in patients with acute cerebral infarction is poor. Homocysteine was an independent protective factor and increased leukocyte count was an independent risk factor for CR.

Key words: PFA-200 P2Y LTA, Acute cerebral infarction, Clopidogrel resistance

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