血小板聚集功能试验在冠心病抗血小板治疗监测中的应用

Platelet Aggregation Test for Monitoring Antiplatelet Treatment on Coronary Artery Disease

目的探讨冠心病患者在用药前后血小板最大聚集率变化,以指导临床用药。方法将120例冠心病患者分成3组:阿司匹林组、氯吡格雷组和联合用药组,分别接受阿司匹林、氯吡格雷以及两者联合治疗。用药前后测定其血小板最大聚集率。结果阿司匹林组与正常对照组及用药前比,花生四烯酸诱导途径诱导的血小板最大聚集率存在显著差异(P<0.01);氯吡格雷组二磷酸腺苷诱导途径存在显著差异(P<0.01);而两者联合用药组4种诱导途径均存在明显差异(P<0.05)。结论阿司匹林或氯吡格雷仅可抑制单一途径诱导的血小板聚集,而联合用药对4个途径均有抑制作用,用药过程中进行监测可指导用药。

Objective To investigate changes of the maximum agglutination of platelet in patients with coronary artery disease （CAD） treated by antiplatelet drugs,and to guide the clinical treatment. Methods 120 patients with CAD were divided into 3 groups： aspirin group,clopidogrel group and dual antiplatelet therapy group,the patients were treated by aspirin,clopidogrel and the dual antiplatelet drugs,respectively. The maximum agglutination of platelet was detected before the treatment and 2 weeks after treatment. Results Compared with the healthy and pretreatment,aspirin and clopidogrel could significantly decrease the maximum agglutination of platelet induce by arachidonic acid and adenosine diphosphate,respectively,the dual antiplatelet therapy could significantly decrease the maximum agglutination of platelet induce by arachidonic acid,adenosine diphosphate,epinephrine and collagen.Conclusion aspirin or clopidogrel could inhibit platelet aggregation induced by the simple pathway,the dual antiplatelet therapy could inhibit platelet aggregation induced by arachidonic acid,adenosine diphosphate,epinephrine and collagen.