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采用血栓弹力图联合血小板功能检测评估先天性心脏病患儿阿司匹林抵抗的发生率:单中心经验

Prevalence of aspirin resistance by thromboelastography plus platelet mapping in children with CHD: a single-centre experience.

作者信息

Berganza Fernando M, Gonzalez de Alba Cesar, Egbe Alexander C, Bartakian Sergio, Brownlee John

机构信息

1Department of General Pediatrics,Driscoll Children's Hospital,Corpus Christi,TX,USA.

2Department of Cardiovascular Medicine,Mayo Clinic,Rochester,MN,USA.

出版信息

Cardiol Young. 2019 Jan;29(1):24-29. doi: 10.1017/S1047951118000021. Epub 2018 Dec 3.

Abstract

RationaleAspirin resistance has been reported in up to 80% of children with cardiovascular defects undergoing surgery. Because of a patient who had embolic stroke while on therapeutic aspirin dose but in whom aspirin resistance was present on his thromboelastography platelet mapping, we chose to obtain thromboelastography platelet mapping on cardiac patients on aspirin to assess their risk. OBJECTIVES: This study evaluates aspirin resistance noted in these patients and their characteristics.Methods and resultsThis is a retrospective study of 25 patients taking aspirin for a month at therapeutic dose. In total, 11 female patients were enrolled. Ages in all subjects were 5 months to 27 years. A total of 19 patients had a Fontan surgery. Three had a cavopulomanary anastomosis, one had a hybrid procedure, and two had coronary anomalies. Compliance was assessed at the time of the clinic visit. Aspirin resistance was defined as platelet inhibition below 50%. Variables evaluated were level of platelet inhibition, age, body mass index, and gender.

摘要

理论依据

据报道,接受手术的患有心血管缺陷的儿童中,高达80%存在阿司匹林抵抗。由于有一名患者在服用治疗剂量的阿司匹林时发生了栓塞性中风,但在其血栓弹力图血小板图谱上显示存在阿司匹林抵抗,我们选择对服用阿司匹林的心脏病患者进行血栓弹力图血小板图谱检查,以评估他们的风险。

目的

本研究评估这些患者中观察到的阿司匹林抵抗情况及其特征。

方法与结果

这是一项对25例服用治疗剂量阿司匹林一个月的患者进行的回顾性研究。共纳入11例女性患者。所有受试者的年龄为5个月至27岁。共有19例患者接受了Fontan手术。3例进行了腔肺吻合术,1例进行了杂交手术,2例有冠状动脉异常。在门诊就诊时评估依从性。阿司匹林抵抗定义为血小板抑制率低于50%。评估的变量包括血小板抑制水平、年龄、体重指数和性别。

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