流式细胞术预测冠心病患者阿司匹林抵抗的研究

目的 利用流式细胞术制定阿司匹林抵抗(AR)的诊断标准,预测冠心病患者阿司匹林抵抗的发生率.方法 采用流式细胞术测定127例冠心病(阿司匹林组103例和空白对照组24例)患者人院时及经治疗7 d后P选择素(CD62P)和纤维蛋白原受体(PAC-1)的表达率.利用ROC曲线法设定AR诊断标准,统计AR在住院冠心病患者中的发生率.结果 阿司匹林组治疗前CD62P(10.16±6.80)%、PAC-1(14.66±10.56)%,治疗后CD62P(5.70±4.28)%、PAC-1(8.93±7.08)%;空白对照组治疗前CD62P(9.14±6.52)%、PAC-1(17.67±11.53)%,治疗后CD62P(7.81±5.72)%、PAG-1(14.97±8.05)%,差异有统计学意义(P＜0.05).根据ROC曲线设定CD62P抑制率＜21.5%或PAC-1抑制率＜17.7%为诊断AR标准,AR在住院冠心病患者中的发生率为17.5%.结论 CD62P抑制率＜21.5%或PAC-1抑制率＜17.7%为AR诊断标准.AR发生率为17.5%.

The study of aspirin resistance in patients with coronary heart disease by flow cytometry

Objective To observe the effect of aspirin on phtelets activation markers in patients with coronary heart disease and set up a diagnostic criteria of aspirin resistance.To preliminarily predict the incidence of aspirin resistance in hospital patients.Methods The subjects were divided into 3 groups:aspirin group(103 cases),control group(24 eases),and healthy control group(23 cases).Using whole blood samples,we detected the ratio of CD62P,PAC-1 expression by flow cytometry(FCM)before and after 7-day treatment and compared the changes of CD62P and PAC-1 expression ratio,then calculated the inhibition ratio of platelets glycoprotein,set up the diagnostic criteria of aspirin resistance with receiver operator characteristic curve(SOC)and calculate the incidenee of aspirin resistance in hospital patients.Results The statisticsl reaults are listed as below:in asptirin group,before treatment CD62P(10.16±6.80)%,PAC-1(14.66±10.56)%,and after treatment CD62P(5.70±4.28)%,PAC-1(8.93±7.08)%,P＜0.01.In control group,before treatment CD62P(9.14±6.52)%,PAC-1(17.67±11.53)%,and after treatment CD62P(7.81±5.72)%,PAG-1(14.97±8.05)%,P＜0.05.According to ROC,the inhibition ratio of CD62P＜21.5% or PAG-1＜17.7% was individually set up asdiagnostic criteria of AR.Our study indicate that the incidence of aspirin resistance in hospital CHD patients is 17.5%.Conclusion There exists platelet activation in CHD patients.CD62P and PAC-1 could be considered as the sensitive index of platelet activation and used in the evaluation of anti-platelet therapy.Aspirin can decrease the expression of CD62P and PAC-1,and inhibit the activation of platelet.According to this study,aspirin resistance really exists in CHD patients.By FCM,the diagnostic criteria of aspirin resistance in CHD is the inhibition ratio of CD62P＜21.5% or PAC-1 ＜17,7% due to aspirin.The incidence of aspirin resistance in hospital CHD patients is 17.5%.