比浊法血小板聚集试验的影响因素研究  

Analysis of influencing factors of turbidimetry for platelet agglutination test

作　　者：石红婷[1] 周伯荣 王融[2] 邓燕华[1] 关海涛[1] 刘子凡[1] 

机构地区：[1]广州医学院附属第三医院神经内科,广州510150 [2]广州医学院附属第三医院检验科,广州510150

出　　处：《国际检验医学杂志》2012年第7期774-776,共3页International Journal of Laboratory Medicine

基　　金：广东省科技计划项目(批文号【2008】146号;项目编号23)

摘　　要：目的在不同的实验条件下,观察影响比浊法血小板聚集试验的因素。方法选择30例健康对照组和204例病例组,观察不同的血小板计数及诱导剂浓度对糖尿病患者餐前与餐后、采血后的检测时间、诱导剂的种类互补等不同试验条件下的血小板聚集率。结果随着血小板计数的减少或增加,血小板聚集率相应的减少或增加;二磷酸腺苷(ADP)、胶原(COL)、花生四烯酸(AA)浓度增加,血小板最大聚集率增大,相应的阿司匹林抵抗(AR)或氯吡格雷抵抗(CR)的检出率增高;服用不同的抗血小板药物,糖尿病患者对以ADP、COL、AA为诱导剂测定的血小板聚集率,其影响不同;未空腹及检测时间超过3h重复性较差;服药2周后,COL、AA诱导的血小板聚集率下降不明的患者,随着时间的延长,6个月后易重新出现CR。结论血小板计数、诱导剂浓度、糖尿病疾病、空腹状态、检测时间与比浊法检测血小板聚集率相关,以ADP、COL、AA作诱导剂检测血小板聚集率较单一的ADP更全面、准确。Objective To investigate the influencing factors of turbidimetry for platelet agglutination test under different experimental conditions.Methods 30 cases of healthy subjects and 204 cases of patents were enrolled.The rate of platelet aggregation（RPA） was detected under different conditions,including platelet counts,inducer concentration and types,diabetes mellitus（DM）,fasting state and detection time.Results With the increase or decrease of platelet counts,RPA varied correspondingly.With the increase of the concentration of adenosine diphosphate（ADP）,collagen（COL） and arachidonic acid（AA）,the maxim RPA and the detection rate of aspirin resistance（AR） or clopidogre resistance（CR） increased.For patients with DM,taking different antiplatelet drugs（aspirin or clopidogrel）,inducers of ADP,COL and AA were with different influence on RPA.None-fasting and detection time over 3 hours could cause poor reproducibility.For patients,in whom RPA did not decreased significantly 2 weeks after treatment by the inducing of COL and AA,with the extension of time,CR could re-emerge.Conclusion Platelet counts,inducer concentration,diabetes mellitus,fasting state and detection time could influence the detection of RPA by turbidimetry,and the RPA was more comprehensive and accurate with combined use of ADP,COL and AA as the inducer than ADP alone.

关 键 词：血小板聚集 血小板聚集抑制剂 血小板计数 比浊法 

分 类 号：R446.1[医药卫生—诊断学]