新型血小板功能分析仪PL-11监测血小板聚集功能的应用价值  

Utilization of a Neotype Platelet Functional Analyzer PL-11 in Monitoring Platelet Aggregation Function

作　　者：孙彬[1] 周杏[2] 朱蕾[1] 韩冰[1] 杜光艳[1] 刘欣欣[1] 孙鹏[1] 张晓萌[1] 董梅[1] 

机构地区：[1]解放军第309医院检验科,北京100091 [2]解放军第307医院输血科,北京100071

出　　处：《标记免疫分析与临床》2015年第6期569-572,576,共5页Labeled Immunoassays and Clinical Medicine

摘　　要：目的 评价连续血小板计数法血小板功能检测仪PL-11监测血小板功能的价值.方法 分别应用SC-2000光学比浊法（LTA）与PL-11连续血小板计数法两种血小板功能检测仪,检测30例急性心肌梗死急诊入院患者,入院时、负荷剂量（600mg）服用氯吡格雷后的第8小时、PCI术后第三天晨起时的血小板聚集功能,分析两种仪器检测结果的相关性及PL-11在氯吡格雷抵抗（clopidogrel resistance,CR）的诊断准确性.结果 在测试人群中,LTA测得最大血小板聚集率（MAR）范围均较PL-11广;所有受试者在刚入院未服用氯吡格雷时,PL-11与LTA不相关（相关系数r=0.35,P=0.058＞0.05）,在术前氯吡格雷大剂量冲击后及术后第三天两次检测的MAR存在相关性（r=0.500和0.571,P＜0.01）;两种仪器三次检测结果均为第一次和第三次明显高于第二次,差异具有统计学意义（P ＜0.05）;PL-11用于诊断CR的ROC曲线下面积为0.798（95％ CI：0.621～0.964）.结论 PL-11连续血小板计数法与“金标准”的（LTA）浊法检测血小板聚集功能具有一定的相关性,其检测结果可供临床及实验室参考.Objective To evaluate the clinical value of platelet function analyzer PL-11 and SC-2000 in monitoring platelet aggregation function. Methods 30 coronary heart disease patients taking clopidogrel as the only antiplatelet drug were included in this study. All subjects were performed platelet function tests by LTA and PL- 11. Tests were measured in 2 hours. Results The range of Max aggregation ratio （MAR） performed by LTA was wider than PL- 11 in both tests. MAR induced by adenosine diphosphate （ADP） between PL- 11 and LTA had no significant correlation（ r = 0. 35 ,P = 0. 058 〉 0.05 ）before patients caplendused clopidogrel when them just admitted to hospital, but had a significant correlation （r = 0. 500 and 0. 571, P 〈 0.01 ） after patients got flushing dose clopidogrel preoperative and postoperative. The results tested by LTA and PL- 11 also showed MAR detected in the first and third time were higher than in the second time obviously （P 〈 0.05 ）. ROC curve showed that the under-curve area of PL-11 using for diagnosing CR was 0. 798 （95% CI： 0. 621-0. 964）. Conclusion PL-11 continuous platelet count has significant correlation with golden standard LTA in evaluating platelet function, and it can be used for clinical laboratory study.

关 键 词：二磷酸腺苷 血小板聚集功能检测 光学比浊法 连续血小板计数 氯吡格雷 

分 类 号：R446.11[医药卫生—诊断学]