评价血小板分析仪PL-11监测正常人短期抗血小板治疗

Evaluation of PL-11 in short-term antiplatelet therapy monitoring

目的通过与4种常见的血小板功能检测方法比较，评价一种新的血小板功能检测方法PL-11。方法临床随机对照试验。2013年7至8月选择解放军医学院2012级健康学生志愿者20名，用PL-11与光比浊法（LTA）、VerifyNow和血栓弹力图（TEG）同时监On．0阿司匹林或者氯吡格雷治疗前后血小板功能变化，分析评价服药前后血小板功能的变化和不同方法的一致性及各方法监测药物治疗反应性的临界值。结果监测阿司匹林治疗时，花生四烯酸诱导的PL-11与LTA、VerifyNow、TEG相关性分别是0．614、0．829、0．697。Bland—Altman分析PL-11与LTA结果，基础值结果偏差为1．94％，治疗期间结果偏差为24．02％。花生四烯酸诱导的PL—ll监测阿司匹林反应性临界值为33．3％。监测氯吡格雷治疗时，二磷酸腺苷诱导的PL-11与LTA、VerifyNow、TEG相关性分别是0．767、0．851、0．608。Bland—Altman分析PL一11与LTA结果在基础值和治疗期间，偏差分别为3．01％、6．56％。二磷酸腺苷诱导PL-11监测氯吡格雷治疗反应性临界值为66％。结论不同血小板功能检测方法监测抗血小板治疗时结果存在差异。PL-11在健康志愿者服用阿司匹林或者氯吡格雷时具有较好的治疗监测能力。（中华检验医学杂志，2014，37：954—957）

Objective To evaluate a new platelet function analyzer PL-11 with three major platelet function methods. Methods A randomized controlled trial was adopted. Totally 20 healthy young students from People＇s Liberation Army Medical School were enrolled in the study during July and August in 2013. Subjects were treated with aspirin or clopidogrel and the platelet function was measured by using of PL- 11, as well as light transmittance aggregometry （LTA）, VerifyNow and thromboelastography （TEG）. Results When monitor aspirin response, correlations between arachidonic acid （ AA ） induced PL-11 and other methods were： LTA, 0.614; VerifyNow, 0.829; TEG, 0.697, respectively. Biases between AA induced PL-11 and LTA were 1.94% at baseline and 24. 02% during aspirin treatment. Cut-off value of aspirin response tested with AA induced PL-11 was 33.3%. When monitor clopidogrel response, correlations between adenosine piphosphate （ADP） induced PL-11 and other methods were：LTA, 0. 767; VerifyNow, 0.851; TEG, 0. 608. Biases between ADP induced PL-11 and LTA were 3.01% at baseline and 6. 56% during clopidogrel therapy. Cut-off value of clopidogrel response tested with ADP induced PL-11 was 66%. Conclusion Results of different platelet function testing methods were not equally effective. PL-11 has a high capability when monitoring short aspirin or clopidogrel response. （Chin J Lab Med,2014,37：954-957）