[1]赵运凤,任军伟,丛玉隆.光电比浊法血小板聚集仪与流式细胞仪检测氯吡格雷药效[J].现代检验医学杂志,2015,30(02):23-26.[doi:10.3969/j.issn.1671-7414.2015.02.007]
　ZHAO Yun-feng,REN Jun-wei,CONG Yu-long.CD62pUsing Light Transmission Aggregometry and Flow Cytometry to Examine the Effect of Clopidogrel[J].Journal of Modern Laboratory Medicine,2015,30(02):23-26.[doi:10.3969/j.issn.1671-7414.2015.02.007]
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光电比浊法血小板聚集仪与流式细胞仪检测氯吡格雷药效()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第30卷
期数:
2015年02期
页码:
23-26
栏目:
论著
出版日期:
2015-03-20

文章信息/Info

Title:
CD62pUsing Light Transmission Aggregometry and Flow Cytometry to Examine the Effect of Clopidogrel
作者:
赵运凤1; 任军伟2; 丛玉隆3
1.湖北省枣阳市第一人民医院,湖北枣阳 441200; 2.兵器工业北京北方医院检验科,北京 100089; 3.解放军总医院西院检验科,北京 100853
Author(s):
ZHAO Yun-feng1; REN Jun-wei2; CONG Yu-long3
1.Zaoyang First People's Hospital, Hubei Zaoyang 441200,China; 2.Department of Clinical Laboratory,BeijingNorth Hospital of China North Industries Group Corporation(CNGC),Beijing 100089,China; 3.Department of Clinical Laboratory,West Building of Chinese PLA General Hospital,Beijing 100853,China
关键词:
血小板聚集;  流式细胞仪;  光电比浊法血小板聚集分析仪;  PAC-1; CD62p
分类号:
R446.11
DOI:
10.3969/j.issn.1671-7414.2015.02.007
文献标志码:
A
摘要:
目的 采用二磷酸腺苷(adenosine phosphate,ADP)诱导光电比浊法血小板聚集分析仪(light transmittance aggregometry,LTA)试验与流式细胞仪(flow cytometry,FC)血小板膜糖蛋白分子PAC-1(Fg,Ca2+,GPⅡb/Ⅲa形成复合物的受体)、CD62p(P选择素)活性百分数实验检测氯吡格雷的抗血小板聚集效果。方法 ①用随机数字表法收集解放军总医院住院的2011年6月～2012年3月急性冠状动脉综合征(acute coronary syndrome,ACS)术后患者71例(包括不稳定型心绞痛、ST段抬高型心肌梗死、非ST段抬高型心肌梗死患者)。男性46例,女性25例,平均年龄69岁(57～92岁)。②患者入院时均先顿服阿司匹林160 mg和氯吡格雷300 mg,之后用氯吡格雷75 mg/d的维持量治疗6个月后,在某次停药10天后,于服药前、服药后2 h采集其前臂静脉血。③同时进行LTA和FC检测,分别得到ADP诱导的患者服药前、后LTA检测的血小板聚集率及药物抑制率(分别用ADPLTA服药前、ADPLTA服药后、ADPLTA-INDU表示); FC检测的PAC-1活性百分数及药物抑制率(分别用PAC-1服药前、PAC-1服药后、PAC-1INHI表示),CD62p活性百分数及药物抑制率(分别用CD62p服药前、CD62p服药后、CD62pINHI表示)。所有参与实验者均签署了知情同意,该研究获得医院伦理委员会批准。结果 ①71例观察对象均进入结果分析。②ADPLTA服药前值分布在0%～97%(73.5±13.7)%,ADPLTA服药后值分布在12%～97%(63.6±16.2)%,两者进行成组数据配对样本t检验(t=-2.082,P=0.041); PAC-1服药前值分布在15.1%～78.9%(49.8±17.8)%,PAC-1服药后值分布在14.5%～78.3%(47.9±17.1)%,两者进行成组数据配对样本t检验(t=3.663,P<0.01); CD62p服药前值分布在1.5%～80.8%(10.9±9.8)%,CD62p服药后值分布在1.4%～41.4%(9.3±6.7)%,两者进行成组数据配对样本t检验(t=2.082,P=0.041)。③ADPLTA-INDU值分布在0%～28.2%(13.8±13.9)%,PAC-1INHI值分布在0.6%～9.1%(3.7±3.8)%,CD62pINHI值分布在0.1%～48.5%(15.0±32.3)%,三者两两之间采用积矩相关系数(Pearson相关系数)判别:ADPLTA-INDU与PAC-1INHI(r=0.297,P=0.012),ADPLTA-INDU与CD62pINHI(r=0.220,P=0.065),PAC-1INHI与CD62pINHI(r=0.736,P<0.001)。结论 FC检测的氯吡格雷药物抑制率与LTA的相应值相关性不好,FC并不适用于血小板聚集功能的临床常规检测,但可作为科学研究及常规结果的辅助性确认方法。
Abstract:
Objective To detect clopidogrel effect with light transmission aggregometry(LTA)and flow cytometry(FC).Methods ①Venous blood samples were taken from 71 inpatient with acute corotary syndrome(ACS)in PLA General Hospital,including unstable anqina,ST segment elevation myocardial infarction and non ST segment elevation myocardial infarction(46 males,25 females)by random number table from June 2011 to March 2012,whose average age was 69(57～92).②All of them were served 160 mg aspirin and 300 mg clopidogrel after they were in hospital in the beginning,and then served with 75 mg/d clopidogrel for 6 months.On some day,firstly,they wererequired withdrawing drug for 10 days,and then venous blood samples were separately taken from them before their served-clopidogrel again and their severd-clopidogrel 2 hours later.③The samples were assayed with LTA and FC simultaneously and the platelet aggregation rates before served-clopidogrel(ADPLTA-before serving),platelet aggregation rates after served-clopidogrel(ADPLTA-after serving),inhibition rates(ADPLTA-INDU),PAC-1 activity percentage before served-clopidogrel(PAC-1before serving),PAC-1 activity percentage after served-clopidogrel(PAC-1after serving),inhibition rates(PAC-1INHI),CD62p activity percentage before served-clopidogrel(CD62pbefore serving),CD62pactivity percentage after served-clopidogrel(CD62pafter serving),inhibition rates(CD62pINHI)were gotten.All volunteers were signed informed consents and the experiment was approved by the hospital ethics committee.Results ①The paired samplest-test was(t=-2.082,P=0.041)between ADPLTA-before serving(0%～97%)and ADPLTA-after serving(12%～97%),the paired samples t-test was(t=3.663,P<0.01)between PAC-1before serving(15.1%～78.9%)and PAC-1after serving(14.5%～78.3%); the paired samples t-test was(t=2.082 and P=0.041)between CD62pbefore serving (1.5%～80.8%)and CD62pafter serving(1.4%～41.4%).②The pearson coeffcient correlation results were:ADPLTA-INDU(0%～28.2%)and PAC-1INHI(0.6%～9.1%)(r=0.297,P=0.012); ADPLTA-INDU(0%～28.2%)andCD62pINHI(0.1%～48.5%)(r=0.220,P=0.065); PAC-1INHI(0.6%～9.1%)and CD62pINHI(0.1%～48.5%)(r=0.736,P<0.001).Conclusion Because the correlation was bad between the inhibitionrates of clopidogrel detected by FC and them by LTA,FC didn't apply to clinical routine examination of the platelet aggregation.But it could be used to scientific researchs and auxiliary confirmation of routine examination results.

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备注/Memo

备注/Memo:
作者简介:赵运凤,女,大专,主管护师,专业:护理学,感染学, E-mail:traveler0910@gmail.com。 任军伟(1979-),并列第一作者,男,硕士研究生,主管技师,专业:临床检验诊断学,免疫学,Tel:13661149064,E-mail:renjw678@126.com。 通讯作者:丛玉隆,男,主任医师,教授,博士生导师,研究方向:血栓与止血,临床血液学,检验学科质量管理,E-mail:yulongc@263.net。
更新日期/Last Update: 2015-03-20