Gurbel Paul A, Becker Richard C, Mann Kenneth G, Steinhubl Steven R, Michelson Alan D
Sinai Center for Thrombosis Research, Sinai Hospital of Baltimore, Baltimore, Maryland, USA.
J Am Coll Cardiol. 2007 Nov 6;50(19):1822-34. doi: 10.1016/j.jacc.2007.07.051. Epub 2007 Oct 23.
Studies focused on patient responsiveness to antiplatelet therapies, particularly aspirin and clopidogrel, have increased in recent years. However, the relations of in vivo platelet function and adverse clinical events to results of ex vivo platelet function tests remain largely unknown. This article describes current methods of measuring platelet function in various clinical and research situations and their advantages and disadvantages, reviews evidence for antiplatelet response variability and resistance, discusses the potential pitfalls of monitoring platelet function, and demonstrates emerging data supporting the positive clinical and treatment implications of platelet function testing.
近年来,聚焦于患者对抗血小板治疗(尤其是阿司匹林和氯吡格雷)反应性的研究有所增加。然而,体内血小板功能及不良临床事件与体外血小板功能测试结果之间的关系仍很大程度上未知。本文描述了在各种临床和研究情况下测量血小板功能的当前方法及其优缺点,回顾了抗血小板反应变异性和抵抗性的证据,讨论了监测血小板功能的潜在陷阱,并展示了支持血小板功能检测具有积极临床和治疗意义的新数据。