PFAP2Y评价服用氯吡格雷的老年心血管病患者的血小板功能

发布时间：2018-06-12 14:38

本文选题：PFA- + PFA　；参考：《南方医科大学学报》2017年04期

【摘要】：目的通过与两种常见的血小板功能检测方法的比较,评价血小板功能分析仪PFA-200的一种新的检测方法监测老年心血管病患者氯吡格雷治疗的应用价值。方法选取2016年3月~8月解放军总医院心内科病房服用氯吡格雷的老年心血管病患者56例,并征集健康志愿者85例,使用PFA P2Y、光学比浊法(LTA)和血栓弹力图(TEG)同时检测所有受试者的血小板功能,评价PFA P2Y分别与LTA和TEG的相关性、符合率。结果 PFA P2Y vs LTA(r=-0.701,P0.001);PFA P2Y vs TEG(r=0.475,P0.001)。PFA P2Y vs LTA的符合率为75%,κ=0.434(P=0.001);PFA P2Y vs TEG的符合率为67.9%,κ=0.242(P=0.046)。以LTA的MARADP(ADP诱导的最大血小板聚集率)50%作为实验室氯吡格雷抵抗标准,作ROC曲线,得PFA P2Y的cut-off值为119s(AUC 0.733,灵敏度75.6%,特异度73.3%)。结论 PFA P2Y与LTA具有较好的相关性和符合率,与TEG的相关性和符合率较差。PFA P2Y可用于监测老年心血管病患者氯吡格雷治疗,cut-off值为119 s,但与临床缺血事件的相关性还有待进一步确认和研究。
[Abstract]:Objective to evaluate the value of a new method of platelet function analyzer PFA-200 in monitoring clopidogrel therapy in elderly patients with cardiovascular diseases. Methods from March to August 2016, 56 elderly patients with cardiovascular diseases who were treated with clopidogrel in the cardiology ward of PLA General Hospital were selected, and 85 healthy volunteers were recruited. The platelet function of all subjects was measured by PFA P2Y, optical turbidimetry (LTA) and thromboelastography (TEG). The correlation between PFA P2Y and LTA and TEG was evaluated, and the coincidence rate was evaluated. Results the coincidence rate of PFA P2Y vs LTAAr-0.701C P0.001P0.001 PFA P2Y vs TEGGR 0.475N P 0.001U. PFA P2Y vs LTA was 75. The coincidence rate of 魏 -0.434 PFAP2Y vs TEG was 67.9%, and that of 魏 0.242P0. 0460.46 渭 g / kg. The coincident rate of PFA P2Y vs TEG was 0.242P0. 046%, the coincident rate of PFA P2Y vs TEG was 75.The coincidence rate of PFA P2Y vs TEG was 67.9%. The maximum platelet aggregation rate (50%) induced by MARADPN was used as the standard of clopidogrel resistance in laboratory. The cut-off value of PFAP2Y was 119sAUC0.733, the sensitivity was 75.6%, and the specificity was 73.3%. Conclusion PFA P2Y has good correlation with LTA. PFA P2Y can be used to monitor clopidogrel in elderly patients with cardiovascular diseases. The cut-off value of clopidogrel is 119 s, but the correlation with clinical ischemic events needs to be further confirmed and studied.
【作者单位】：解放军总医院南楼检验科;北京大学第一医院检验科;解放军总医院心血管内科;中国人民解放军装备发展部第六十一研究所门诊部;
【分类号】：R54

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