冠心病患者血小板功能检测的意义及应用前景

Research advances in monitoring platelet function in patients with coronary artery disease

抗血小板治疗和冠状动脉内支架植入术作为冠心病患者主要的药物治疗和血运重建方式可以显著降低患者的死亡率。研究显示在一部分冠心病患者接受了常规阿司匹林和氯吡格雷抗血小板治疗后仍然会发生不良心脏事件，因此对阿司匹林及氯吡格雷的抵抗现象越来越引起关注。通过临床监测血小板功能可以及时识别这部分患者并且制定个体化的治疗策略，从而可能使这部分患者获益。目前为止很多的血小板功能检测手段已经应用于临床，用来监测及评价冠心病患者预防和治疗血栓事件的疗效。这些检测方法可以针对不同的抗血小板药物包括阿司匹林、氯吡格雷以及血小板膜糖蛋白（GPⅡb／Ⅲa）拮抗剂。通过不同检测方法测定的抗血小板药物抵抗的结果不同，并且和临床不良事件的相关性需要进一步的验证。

Antiplatelet therapy and stent implantation have been the dominant treatment to reduce the mortality of patients with coronary artery disease. Recently, studies have showed that adverse cardiac events still occur in part of patients with coronary artery disease after the antiplatelet treatment with aspirin and/or clopidogrel. Thus, resistance to aspirin and clopidogrel has attracted increasing attention. It will be great benefit to these patients who were identified resistance and made tailoring antiplatelet therapy So far many platelet function tests has been used in clinical to monitor the reaction of the antiplatelet drugs for prevention and treatment of thrombosis in patients with coronary artery disease. These monitoring tests may be chosen based on different antiplatelet drugs including aspirin, clopidogrel and GP Ⅱb/Ⅲaa antagonist. The results of antiplatelet drug resistance may be different due to different platelet function methods, thus the related clinical adverse events needs further verification.