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目的研究不同检测方法对阿司匹林抵抗疗效的监测作用。方法对57名口服阿司匹林的老年高血压患者分别进行光学法血小板聚集率(platelet aggregationtest,PAgT),血栓弹力图(thrombelastography,TEG),血、尿11-脱氢血栓素B2(11-dehydrothromboxane B2,11-DH-TXB2)浓度及P-选择素(P-seletin)表达的检测,并进行对比分析。结果 TEG血小板图在阿司匹林抵抗组(aspirin resistance,AR),阿司匹林半抵抗组(aspirin semi-responders,ASR),阿司匹林敏感组(aspirin sensitive,AS)间两两比较中均有显著差异(P均<0.01)。血、尿11-DH-TXB2含量,P-选择素表达率在AR组和ASR组明显升高(P均<0.05)。PAgT,TEG血小板图,血、尿11-脱氢血栓素B2及P-选择素这些方法间有一定的相关性(相关系数r均>0.4,P均<0.01)。与PAgT,血尿11-DH-TXB2这几种临床常用检测方法相比,TEG血小板图对AR检出的灵敏度(81.48%)和特异性(85.71%)更高,与P-选择素的一致性更高(K=0.822,P<0.001)。结论 TEG血小板图检测对于老年高血压患者使用阿司匹林疗效具有较高的临床应用价值。有助于指导制定个体化的抗血小板治疗方案。
Objective To study the monitoring effect of different test methods on aspirin resistance. Methods Fifty-seven elderly hypertensive patients with oral aspirin were randomly divided into three groups: platelet aggregation test (PAgT), thrombelastography (TEG), blood, urine 11-dehydrothromboxane B2 11-DH-TXB2) and P-selectin (P-seletin) expression were detected and compared. Results The TEG platelets showed significant differences in any pairwise comparison of aspirin resistance (AR), aspirin semi-responders (ASR) and aspirin sensitive (AS) (P < 0.01). The content of 11-DH-TXB2 in blood and urine and the expression of P-selectin in AR group and ASR group were significantly increased (all P <0.05). PAgT, TEG platelet, blood, urine 11-DHT B2 and P-selectin have some correlations (correlation coefficient r> 0.4, P <0.01). The sensitivity and specificity (81.48%) and specificity (85.71%) of TEG platelet to AR were higher than those of PAgT and hematuria 11-DH-TXB2 Higher (K = 0.822, P <0.001). Conclusion The TEG platelet test has a high clinical value for the treatment of elderly hypertensive patients with aspirin. Help to guide the development of individual anti-platelet therapy programs.