Darling Chad E, Michelson Alan D, Volturo Gregory A, Przyklenk Karin
Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA 01655, USA.
J Thromb Thrombolysis. 2009 Jul;28(1):31-7. doi: 10.1007/s11239-008-0242-x. Epub 2008 Jul 4.
Risk stratifying patients with potential acute coronary syndromes (ACS) in the Emergency Department is an imprecise and resource-consuming process. ACS cannot be ruled in or out efficiently in a majority of patients after initial history, physical exam, and ECG are analyzed. This has led to a reliance on cardiac markers of myocardial necrosis as a key means of making the diagnosis. Commonly used markers, CK-MB and troponin-I, have the drawback of delayed sensitivity. This has led to an ongoing search for one or more marker(s) that would be more sensitive in early ACS. With the central role that platelets play in the pathophysiology of coronary thrombosis, measures of platelet function represent one potential area where an early ACS marker might be identified. This review will focus on selected tests/markers of platelet function that have shown some promise with respect to the risk stratification of patients with potential ACS.
在急诊科对潜在急性冠状动脉综合征（ACS）患者进行风险分层是一个不准确且耗费资源的过程。在分析初始病史、体格检查和心电图后，大多数患者无法有效排除或确诊ACS。这导致依赖心肌坏死的心脏标志物作为诊断的关键手段。常用的标志物肌酸激酶同工酶（CK-MB）和肌钙蛋白I具有敏感性延迟的缺点。这促使人们不断寻找一种或多种在早期ACS中更敏感的标志物。鉴于血小板在冠状动脉血栓形成病理生理学中所起的核心作用，血小板功能检测是可能找到早期ACS标志物的一个潜在领域。本综述将聚焦于已在潜在ACS患者风险分层方面显示出一定前景的特定血小板功能检测/标志物。
