抗血小板抵抗——它是否存在以及如何检测？
Antiplatelet Resistance-Does it Exist and How to Measure it?
作者信息
Saraf S, Bensalha I, Gorog D A
机构信息
Cardiology Department, East and North Hertfordshire NHS Trust, UK.
出版信息
Clin Med Cardiol. 2009 Sep 3;3:77-91.
Aspirin and clopidogrel are the most commonly used antiplatelet agents in patients with coronary artery disease. The existence of resistance to these agents has been a controversial issue and new drugs are being developed to overcome this problem. Laboratory tests, which can identify resistance and correlate this with clinical outcome, are being studied in order to identify patients at risk of future thrombotic events. We discuss the evidence for the existence of antiplatelet resistance-both in the laboratory and in the clinical setting. So far, platelet aggregometry has been considered the gold standard test, but is very operator dependant, time consuming, and has shown little correlation with other available tests of antiplatelet resistance. We discuss the available tests of platelet function, their limitations, and evidence for their use. A simple, rapid, near-patient test, which is affordable and useful in the clinical (not just laboratory) setting, could allow risk stratification of patients and individualization of antiplatelet medication to improve outcome.
阿司匹林和氯吡格雷是冠心病患者最常用的抗血小板药物。对这些药物存在抵抗性一直是一个有争议的问题，目前正在研发新药来克服这一问题。正在研究能够识别抵抗性并将其与临床结果相关联的实验室检测方法，以便确定有未来血栓形成事件风险的患者。我们讨论了在实验室和临床环境中存在抗血小板抵抗性的证据。到目前为止，血小板聚集试验一直被认为是金标准检测方法，但它非常依赖操作人员，耗时且与其他可用的抗血小板抵抗性检测方法相关性很小。我们讨论了现有的血小板功能检测方法、它们的局限性以及使用这些方法的证据。一种简单、快速、适用于床边检测的方法，价格实惠且在临床（不仅仅是实验室）环境中有用，可对患者进行风险分层并实现抗血小板药物的个体化，以改善治疗结果。
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