VerifyNow-P2Y12法和光密度比浊法检测血小板高反应与预测氯吡格雷治疗老年冠状动脉性心脏病患者经皮冠状动脉介入术后临床缺血事件的意义

被引：6

作者：

罗裕 ^{[1
]}

孙文竹 ^{[2
]}

徐剑锋 ^{[2
]}

刘学波 ^{[1
]}

庄少伟 ^{[1
]}

姚义安 ^{[1
]}

王小东 ^{[1
]}

来晏 ^{[1
]}

机构：

[1] 同济大学附属东方医院心内科

[2] 复旦-文安德遗传流行病学研究中心生命科学院

来源：

上海医学 | 2013年 / 36卷 / 09期

关键词：

氯吡格雷; 血小板聚集率; 光密度比浊法; VerifyNow-P2Y12法; 冠状动脉性心脏病; 支架;

D O I：

暂无

中图分类号：

R541.4 [冠状动脉（粥样）硬化性心脏病（冠心病）];

学科分类号：

1002 ; 100201 ;

摘要：

目的明确VerifyNow-P2Y12法和光密度比浊法(LTA)检测老年冠状动脉性心脏病(简称冠心病)患者氯吡格雷疗效的相关性,并比较这两种方法预测老年冠心病患者经皮冠状动脉介入治疗(PCI)术后临床缺血事件的意义。方法连续入选160例年龄≥60岁的冠心病植入冠状动脉支架术患者,服用氯吡格雷≥1周后,采用VerifyNow法和LTA同时检测二磷酸腺苷(ADP)诱导的血小板聚集功能,将VerifyNow法检测出血小板聚集反应单位(PRU)≥230或LTA检测出最大血小板聚集率(MPAR)≥46%定义为治疗后血小板高反应(HPR)。采用双变量相关分析和简单线性回归分析评估两种方法检测结果的相关性。所有患者随访6个月,比较两种方法检测出的HPR预测临床缺血事件的敏感性。结果采用VerifyNow法检测出HPR患者44例(27.5%),LTA检测出HPR患者52例(32.5%),两者间的差异无统计学意义(P>0.05)。PRU与MPAR值呈正相关(r=0.623 15,P=0.037),线性回归方程Y(VerifyNow法)=2.015 X(LTA)+110.2。VerifyNow法检测出的HPR患者中总临床缺血事件的发生率(27.1%)显著高于同法检测的非HPR患者(6.0%,OR=6.53,95%CI为2.61～16.32,P=0.000),而LTA检测出的HPR患者中总临床缺血事件的发生率(17.2%)有高于同法检测的非HPR患者(9.3%)的趋势,但差异无统计学意义(OR=2.33,95%CI为0.92～5.91,P=0.074)。结论 VerifyNow法和LTA均可检测氯吡格雷治疗老年冠心病患者PCI术后HPR。HPR患者PCI后6个月的临床缺血事件发生率高于非HPR者;VerifyNow法检测出的HPR预测临床缺血事件的敏感性高于LTA检测出的HPR。

引用

页码：757 / 761

页数：5

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