氯吡格雷抗血小板功能的两种检测方法比较

目的氯吡格雷抗血小板功能的两种检测方法比较:Verifynow抗血小板治疗监测系统与流式细胞仪法.方法随机收集72例门诊、住院患者静脉血标本,同时采用Verifynow抗血小板治疗监测系统与流式细胞仪法检测血小板聚集功能.结果 Verifynow的测试结果P2Y12 Reaction Units(PRU)19例<240(26.4%);血小板膜糖蛋白分子PAC-1(Fg、Ca2+与血小板GPⅡb/Ⅲa形成复合物的受体)活性值主要集中在20-60,2例<20,12例>60;血小板膜糖蛋白分子CD62p(P选择素)活性值主要集中在10以下,3例>20;血小板膜糖蛋白分子PAC-1与CD62p活性值呈正相关(r=0.812,P<0.01);PAC-1、CD62p的活性值分别与PRU呈正相关(r=0.565,P<0.01;r=0.314,P<0.01);PRU与Verifynow测试的血小板聚集抑制百分率(INHI)呈负相关(r=-0.0802,P<0.01).结论 PAC-1、CD62p活性值与PRU呈正相关,相关性良好,PRU与INHI呈负相关.氯吡格雷抗血小板功能的两种检测方法存在同一性效用,但流式细胞仪法检测过程繁琐,对检验人员操作水平要求严格,若想得到药物的具体效用结果,必须在服药前、后分别抽血取样测定才能得出药物的抑制率;Verifynow操作简单快速,只需在服药后抽取一份样本即可得到样本的聚集基础值、服药后聚集值和药物的抑制率.

Antiplatelet function of clopidogrel: A comparative study of its two detection methods

Objective To compare the efficiency of verifynow antiplatelet treatment monitor system and flow cytometer in detecting the antiplatelet function of clopidogrel.Methods Venous blood samples were randomly taken from 72 outpatients and inpatients.Platelet aggregation function was assayed with the verifynow antiplatelet treatment monitor system and flow cytometer.Results The P2Y12reaction unit(PRU) detected with the verifynow antiplatelet treatment monitor system was <240 in 19 individuals(26.4%).The active value of platelet membrane glucoprotein molecule PAC-1(receptor of Fg,Ca2+ and GP Ⅱb / Ⅲa complex) was 20-60 in most individuals,<20 in 2 individuals,and >60 in 12 individuals.The active value of platelet membrane glucoprotein molecule CD62p(P selectin) was <10 in most individuals and >20 in 3 individuals.The active value of PAC-1 was positively correlated with that of CD62p(r=0.812,P<0.01).The active value of PAC-1 and CD62p was positively correlated with the PRU(r=0.565,r=0.314,P<0.01).The PRU was negatively correlated with inhibition percentage of platelet aggregation detected with the verifynow antiplatelet treatment monitor system(r=-0.080 2,P<0.01).Conclusion The efficiency of verifynow antiplatelet treatment monitor system and flow cytometer is similar in detecting the antiplatelet function of clopidogrel.However,it is more tedious to use flow cytometer than to use verifynow antiplatelet treatment monitor system in detecting the antiplatelet function of clopidogrel.