TEG对老年高血压患者阿司匹林疗效监测的研究  

Experimental Monitoring of Aspirin Efficacy in elderly hypertensive patients by TEG

作　　者：杨蓉[1] 焦洁茹[1] 林青[1] 李嫣然[1] 王熠华[1] 徐志红[1] 王学锋[2] 丁秋兰[2] 吴方[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院老年科,上海200025 [2]上海交通大学医学院附属瑞金医院临床输血科,上海200025

出　　处：《中国实验诊断学》2010年第8期1205-1208,共4页Chinese Journal of Laboratory Diagnosis

基　　金：上海市科学技术委员会资助(074119601)

摘　　要：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 We aim to study the different test methods to monitor the efficacy of the role of aspirin resistance. Meth- otis The AA and ADP induced platelet aggregation test（PAgT）, the thrombelastography platelet mapping test（TEG）, the serum and the urinary 11-DH-TXB2 and P-seletin were performed on the 57 elderly hypertensive patients with oral aspirin. Results The patients were divided into aspirin resistance group （AR）, aspirin semi-responders group （ASR） and aspirin sensitive group （AS）. The thrombelastography platelet mapping test in three groups were significantly different（ P 〈 0.01 ）. The serum and the urinary l l-DH- TXB2 and P-seletin expression rate were significantly higher in AR group and ASR group than in AS group（ P 〈 0.05） .The PAgT, the TEG,tbe serum and the urinary ll-DH-TXB2 and the P-seletin,which have a certain correlation（r〉 0.4, P 〈 0.01） .The sensitivity and specificity of thrombelastography platelet mapping is higher than other test methods. And the consistency between thrombelas- tography platelet mapping and P-seletin was the highest in all of test methods we used（K = 0. 822, P 〈 0. 001）. Conclusion By the thrombelastography platelet mapping test, we can evaluate the therapeutic effect of aspirin, guide clinical treatment, in particular, devel- op individualized anti-platelet treatment programs.

关 键 词：阿司匹林抵抗 血小板聚集率 血栓弹力图血小板图 11-脱氢-血栓素B2 P-选择素 

分 类 号：R544.1[医药卫生—心血管疾病]