血栓弹力图花生四烯酸诱导血小板聚集率与临床及实验室指标的相关性分析  

Application of thrombelastography in detection of AA-induced platelet aggregation and its clinical and laboratory parameters

作　　者：李晓利[1] 范利[2] 张金花[1] 张金萍 王强[1] 孙沛[1] 白秉学[1] 王耀辉[1] 

机构地区：[1]解放军309医院干部病房,北京100091 [2]解放军总医院南楼临床部 [3]解放军305医院医务部

出　　处：《中华老年心脑血管病杂志》2016年第10期1030-1033,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：国家自然科学基金(81300252)

摘　　要：目的探讨服用阿司匹林患者行血栓弹力图(thrombelastography,TEG)检测花生四烯酸(AA)诱导的血小板聚集率(AA%)受哪些临床因素及实验室指标的影响。方法选择2008年4月~2010年7月驻京部队干休所,连续≥1个月服用阿司匹林75~100mg/d的老年患者424例,采用AA诱导的TEG法检测AA%,按四分位法将患者分为Q1组(AA%=0.15%),Q2组[AA%=(8.82±4.73)%],Q3组[AA%=(31.38±10.05)%]和Q4组[AA%=(77.91±15.91)%],每组106例。分析AA%的影响因素。结果 Q4组TC和LDL水平明显高于Q1组、Q2组和Q3组(P<0.05)。多元线性回归分析显示,TC(95%CI:0.20~0.69,P=0.000)和服用他汀药物(95%CI:0.10~1.38,P=0.023)与AA%呈正相关;而服用硝酸酯类药物与AA%呈负相关(95%CI:-1.75^-0.38,P=0.003)。结论 TEG法AA诱导AA%受体内血脂及血糖水平的影响,他汀类药物减弱阿司匹林抗血小板作用,而硝酸酯类则增强其作用。Objective To study the effect of clinical and laboratory parameters on AA-induced platelet aggregation detected by thromboelastography（TEG）in patients taking aspirin.MethodsFour hundred and twenty-four elderly patients who took 75-100 mg aspirin daily for over a month and accepted treatment in our hospital from April 2008 to April 2010 were included in this study.Their AA-induced platelet aggregation was detected by TEG.Results Univariate correlation analysis showed that cholesterol,triglyceride,LDL,fasting blood glucose were positively correlated with platelet aggregation（P〈0.05）.Multivariate linear regression analysis displayed that cholesterol and statins were positively correlated with platelet aggregation（95%CI：0.20-0.69,P=0.000;95%CI：0.10-1.38,P=0.023）whereas nitrates were negatively correlated with platelet aggregation（95%CI：-1.75--0.38,P=0.003）.Conclusion AA-induced platelet aggregation detected by TEG is affected by blood lipid and glucose levels in patients taking aspirin.Statins reduce whereas nitrates increase the antiplatelet effect of aspirin.

关 键 词：血栓弹力描记术 花生四烯酸类 血小板聚集 阿司匹林 血糖 

分 类 号：R446.1[医药卫生—诊断学]