血小板聚集功能检测方法及参数的探索与研究

目的采用5种血小板聚集功能分析仪探讨研究血小板聚集功能检测的可靠方法与准确参数。方法利用二磷酸腺苷(ADP)诱导光比浊血小板聚集仪(LTA)实验,流式细胞仪(FC)血小板膜糖蛋白分子PAC-1(Fg、Ca~(2+)、GPⅡb/Ⅲa形成复合物的受体)、CD62p(P选择素)活化百分率检测实验,英诺华PL-11血小板分析仪实验,VerifyNow抗血小板治疗监测系统实验(VerifyNow)与血栓弹力图实验(TEG)同时检测对照组与单服用氯吡格雷组的血小板聚集功能。结果(1)对照组与患者组ADP%,ADP激活的PAC-1、CD62p受体活化百分率,MAR%,INHI%,TEG测得ADP诱导的MA(mm)值6个参数差异有统计学意义(P0.05);BASE、P2Y12受体的PRU,凝血酶诱导的MA(mm)值3个参数差异无统计学意义(P0.05)。(2)ADP%与(100-INHI)%,MAR%,ADP激活的CD62p、PAC-1受体活化百分率呈正相关(r分别是0.565、0.939、0.769和0.583,P0.05);与TEG测得ADP诱导的血小板聚集率值(%Agg)无相关性(r=0.127,P0.05)。结论 (1)氯吡格雷有抗血小板聚集的效果。(2)LTA操作便捷、廉价、结果稳定,在医院普及率高,是临床监测血小板聚集功能的首选方法。

Investigation of detection methods for aggregation function of platelets

Objective To adopt 5 kinds of platelets aggregation function analyzer to explore and study the reliable method for detecting the platelets aggregation function and accurate parameters .Methods The platelets aggregation function in the control group and the single clopidogrel group was simultaneously detected by utilizing the ADP induced light turbidimetric platelet aggre‐gation analyzer (LTA) test ,flow cytometry for PAC‐1(receptor of Fg ,Ca2+ ,GPⅡb/Ⅲa forming complex) and CD62p(P selectin) activation percentage detection test ,Innova PL‐11 for platelets analysis test ,VerifyNow anti‐platelet therapy monitoring system and thrombelastogram(TEG) .Results (1)The 6‐parameter differences of ADP% ,PAC‐1 and CD62p receptor activation percentage ac‐tivated by ADP ,MAR% ,INHI% ,ADP induced MA value(mm) detected by TEG had statistical differences between the control group and the case group(P< 0 .05);PRU of BASE and P2Y12 receptor ,thrombin induced MA value (mm) had no statistical differences between these two groups(P>0 .05) .(2)ADP% was positively correlated with (100‐INHI)% ,MAR% ,ADP activated CD62p and PAC‐1 receptor activation percentage(r=0 .565 ,0 .939 ,0 .769 ,0 .583 ,P<0 .05 );while which had no correlation with ADP induced platelets aggregation value(% Agg) detected by TEG(r=0 .794 ,0 .715 ,0 .889) .Conclusion (1)Clopidogre has the anti‐platelets effect .(2)LTA is easily operating ,cheap and stable in detection results ,has high popularizing rate in hospitals and is the first option method for clinically monitoring the platelets aggregation function .