McGlasson David L, Shah Anand D, Fritsma George A
59th Clinical Research Division, Wilford Hall Medical Center, Lackland AFB, San Antonio, Texas 78236-9908, USA.
Blood Coagul Fibrinolysis. 2011 Oct;22(7):583-7. doi: 10.1097/MBC.0b013e328349a2ba.
We compared the ability of four test systems to detect platelet P2Y12 (ADP receptor) blockade by clopidogrel. The systems were the INNOVANCE PFA P2Y cartridge (PFA P2Y), the Accumetrics VerifyNow P2Y12 cartridge (VN P2Y12), whole blood aggregometry (WBA) using 5 (WBA 5) and 10 (WBA 10) μmol/l ADP, and light transmittance aggregometry (LTA) using 20 (LTA 20) μmol/l ADP. Blood was collected in 3.2% citrate from 101 preangiography participants who had received 300-600 mg of clopidogrel within 6-24 h or 75 mg daily for at least 7 days. Blood was also collected in 3.8% citrate for the PFA P2Y. Cut-offs indicating blockade were PFA P2Y, more than 106 s; VN P2Y12, less than 20%, less than 235 Plavix resistance unit (PRU); WBA 5, less than 5 ohms; WBA 10, less than 8 ohms; and LTA 20, less than 50% aggregation. Percentage positives were PFA P2Y (3.2% citrate), 59%; PFA P2Y (3.8% citrate), 95%; VN P2Y12, 60%; VN P2Y12 PRU, 50%; WBA 5, 88%; WBA 10, 89%; and LTA 20, 72%. Percentage agreements were PFA P2Y 3.2% to VN P2Y12, 71%; PFA P2Y 3.2% to WBA 5 and 10, 64 and 65%, respectively; PFA P2Y 3.2% to LTA 20, 69%; PFA P2Y 3.8% to VN P2Y12, 71%, and to VN P2Y12 PRU, 60%; PFA P2Y 3.8% to WBA 5 and 10, 90% for both; PFA P2Y 3.8% to LTA 20, 76%; VN P2Y12 to WBA 5 and 10, 68 and 67%, respectively; and VN P2Y12 to LTA 20, 72%. PFA P2Y (3.2% citrate) detection compared favorably to VN P2Y12. The same system at 3.8% citrate compared more closely to WBA 5 and WBA 10.
我们比较了四种检测系统检测氯吡格雷对血小板P2Y12（ADP受体）阻断作用的能力。这些系统分别是INNOVANCE PFA P2Y检测盒（PFA P2Y）、Accumetrics VerifyNow P2Y12检测盒（VN P2Y12）、使用5（WBA 5）和10（WBA 10）微摩尔/升ADP的全血凝集试验（WBA）以及使用20（LTA 20）微摩尔/升ADP的透光率凝集试验（LTA）。从101名血管造影术前参与者中采集3.2%枸橼酸盐抗凝的血液，这些参与者在6 - 24小时内接受了300 - 600毫克氯吡格雷，或每天服用75毫克至少7天。也采集3.8%枸橼酸盐抗凝的血液用于PFA P2Y检测。表明阻断的临界值为：PFA P2Y，超过106秒；VN P2Y12，小于20%，小于235普拉格雷抵抗单位（PRU）；WBA 5，小于5欧姆；WBA 10，小于8欧姆；LTA 20，小于聚合率50%。阳性百分比分别为：PFA P2Y（3.2%枸橼酸盐），为59%；PFA P2Y（3.8%枸橼酸盐），为95%；VN P2Y12，为60%；VN P2Y12 PRU，为50%；WBA 5，为88%；WBA 10，为89%；LTA 20，为72%。一致性百分比为：PFA P2Y 3.2%与VN P2Y12，为71%；PFA P2Y 3.2%与WBA 5和WBA 10，分别为64%和65%；PFA P2Y 3.2%与LTA 20，为69%；PFA P2Y 3.8%与VN P2Y12，为71%，与VN P2Y12 PRU，为60%；PFA P2Y 3.8%与WBA 5和WBA 10，两者均为90%；PFA P2Y 3.8%与LTA 20，为76%；VN P2Y12与WBA 5和WBA 10，分别为68%和67%；VN P2Y12与LTA 20，为72%。PFA P2Y（3.2%枸橼酸盐）检测与VN P2Y12相比表现良好。同一系统在3.8%枸橼酸盐时与WBA 5和WBA 10的比较更为接近。
