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采用 Multiplate 全血聚集仪和透光比浊法评估阿司匹林反应。

Evaluation of aspirin response by Multiplate whole blood aggregometry and light transmission aggregometry.

机构信息

Department of Cardiology, Aarhus University Hospital, Skejby, Denmark.

出版信息

Platelets. 2009 Sep;20(6):415-20. doi: 10.1080/09537100903100643.

Abstract

Several studies indicate that a biochemically reduced response to aspirin increases the risk of cardiovascular events. This study was designed to investigate the performance of Multiplate whole blood aggregometry as regards assessment of platelet function prior to and after aspirin treatment, and to compare it with light transmission aggregometry (LTA). We included 21 healthy individuals and 43 patients with documented coronary artery disease (CAD). Platelet aggregation induced by arachidonic acid 0.5 mM was measured in duplicate by Multiplate aggregometry and LTA in healthy individuals before aspirin treatment and in all participants on four consecutive days during treatment with 75 mg aspirin daily. Optimal compliance was confirmed by complete suppression of serum thromboxane B(2) in all participants. Employing the Multiplate, the coefficient of variation (CV) was lower at baseline (CV = 8%) than during aspirin treatment in both healthy individuals (CV = 46%) and patients (CV = 46%). During aspirin treatment, the repeatability of LTA was superior to Multiplate measurements. However, the Multiplate was superior to LTA as regards the ability to discriminate platelet response before and after aspirin treatment. In conclusion, the repeatability of Multiplate aggregometry was good before aspirin treatment, whereas the CV was quite high during aspirin treatment in both healthy individuals and patients. However, the Multiplate device was fully capable of assessing platelet function prior to and after treatment with aspirin. Clinical studies are needed to investigate whether a high platelet aggregation level measured by Multiplate whole blood aggregometry during aspirin treatment is associated with a poor clinical outcome.

摘要

几项研究表明,阿司匹林生物化学反应降低会增加心血管事件的风险。本研究旨在探讨全血比浊法(Multiplate)在阿司匹林治疗前后评估血小板功能的性能,并与光传输比浊法(LTA)进行比较。我们纳入了 21 名健康个体和 43 名经证实的冠心病(CAD)患者。在健康个体服用阿司匹林前和所有参与者连续 4 天每天服用 75 毫克阿司匹林治疗期间,通过 Multiplate 聚集仪和 LTA 分别测量了双份 0.5mM 花生四烯酸诱导的血小板聚集。所有参与者的血清血栓素 B2 完全抑制,确认了最佳的依从性。使用 Multiplate,在健康个体(CV=46%)和患者(CV=46%)中,基线时的变异系数(CV)低于阿司匹林治疗时(CV=8%)。在阿司匹林治疗期间,LTA 的重复性优于 Multiplate 测量。然而,在区分阿司匹林治疗前后血小板反应方面,Multiplate 优于 LTA。总之,在阿司匹林治疗前,Multiplate 聚集仪的重复性良好,而在健康个体和患者中,阿司匹林治疗期间的 CV 相当高。然而,Multiplate 设备完全能够评估阿司匹林治疗前后的血小板功能。需要进行临床研究,以探讨在阿司匹林治疗期间通过 Multiplate 全血聚集仪测量的高血小板聚集水平是否与不良临床结局相关。

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