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抗血小板治疗实验室监测之我见

朱铁楠

朱铁楠. 抗血小板治疗实验室监测之我见[J]. 协和医学杂志, 2018, 9(2): 123-126. doi: 10.3969/j.issn.1674-9081.2018.02.006
引用本文: 朱铁楠. 抗血小板治疗实验室监测之我见[J]. 协和医学杂志, 2018, 9(2): 123-126. doi: 10.3969/j.issn.1674-9081.2018.02.006
Tienan Zhu. Antiplatelet Therapy: the Role of Platelet Function Monitoring[J]. Medical Journal of Peking Union Medical College Hospital, 2018, 9(2): 123-126. doi: 10.3969/j.issn.1674-9081.2018.02.006
Citation: Tienan Zhu. Antiplatelet Therapy: the Role of Platelet Function Monitoring[J]. Medical Journal of Peking Union Medical College Hospital, 2018, 9(2): 123-126. doi: 10.3969/j.issn.1674-9081.2018.02.006

抗血小板治疗实验室监测之我见

doi: 10.3969/j.issn.1674-9081.2018.02.006
详细信息
    作者简介:

    朱铁楠:电话:010-69155027, Email:zhutn@pumch.cn

  • 中图分类号: R446.11; R55

Antiplatelet Therapy: the Role of Platelet Function Monitoring

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  • 摘要: 抗血小板药物在各种动脉血栓性疾病防治中具有重要地位。虽然目前抗血小板药物多采用固定剂量给药,但不同患者对抗血小板治疗的反应性存在明显差异。治疗后的血小板高反应性或低反应性可能与血栓事件或出血事件风险相关。基于血小板功能检测的个体化抗血小板治疗方案可能有助于预防血栓或出血不良事件的发生,但目前仍缺乏上述治疗策略能够最终改善患者预后的确切临床证据。迄今为止,对于接受抗血小板治疗的患者是否应常规进行实验室监测仍存在诸多争议。本文对抗血小板治疗反应多样性的成因及血小板功能检测是否可用于指导个体化抗血小板治疗进行讨论。
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    [2] Michelson AD, Bhatt DL. How I use laboratory monitoring of antiplatelet therapy?[J]. Blood, 2017, 130: 713-721. doi:  10.1182/blood-2017-03-742338
    [3] Gurbel PA, Becker RC, Mann KG, et al. Platelet function monitoring in patients with coronary artery disease [J]. J Am Coll Cardiol, 2007, 50: 1822-1834. doi:  10.1016/j.jacc.2007.07.051
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    [5] Jovanovic L, Antonijevic N, Novakovic T, et al. Practical aspects of monitoring of antiplatelet therapy [J]. Semin Thromb Hemost, 2017, 43: 14-23. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=f94cca36d07f692d877ca43f77dcb8e1
    [6] Patrono C. The multifaceted clinical readouts of platelet inhibition by low-dose aspirin [J]. J Am Coll Cardiol, 2015, 66:74-85. doi:  10.1016/j.jacc.2015.05.012
    [7] Price MJ, Berger PB, Teirstein PS, et al.Standard-vs high-dose clopidogrel based on platelet function testing after percutaneous coronary intervention: the GRAVITAS randomized trial [J]. JAMA, 2011, 305: 1097-1105. doi:  10.1001/jama.2011.290
    [8] Collet JP, Cuisset T, Rang'e G, et al. Bedside monitoring to adjust antiplatelet therapy for coronary stenting [J]. N Engl J Med, 2012, 367: 2100-2109. doi:  10.1056/NEJMoa1209979
    [9] Cayla G, Cuisset T, Silvain J, et al. Platelet function monitoring to adjust antiplatelet therapy in elderly patients stented for an acute coronary syndrome (ANTARCTIC): an open-label, blinded-endpoint, randomised controlled superiority trial [J]. Lancet, 2016, 388: 2015-2022. doi:  10.1016/S0140-6736(16)31323-X
    [10] Windecker S, Kolh P, Alfonso F, et al. 2014 ESC/EACTS Guidelines on myocardial revascularization: The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)Developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI) [J]. Eur Heart J, 2014, 35: 2541-2619. doi:  10.1093/eurheartj/ehu278
    [11] Levine GN, Bates ER, Blankenship JC, et al. 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions [J]. J Am Coll Cardiol, 2011, 58: e44-e122. http://www.researchgate.net/publication/281297740_ACCFAHASCAI_guideline_for_percutaneous_coronary_intervention_executive_summary_a_report_of_the_American_College_of_Cardiology_FoundationAmerican_Heart_Association_Task_Force_on_Practice_Guidelines_and
    [12] Valgimigli M, Bueno H, Byrne RA, et al. 2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS: The Task Force for dual antiplatelet therapy in coronary artery disease of the European Society of Cardiology (ESC) and of the European Association for Cardio-Thoracic Surgery (EACTS) [J]. Eur Heart J, 2017. doi:  10.1093/eurheartj/ehx419. [Epub ahead of print].
    [13] 中华医学会心血管病学分会, 中华心血管病杂志编辑委员会.抗血小板药物治疗反应多样性临床检测和处理的中国专家建议[J].中华心血管病杂志, 2014, 42: 986-991. doi:  10.3760/cma.j.issn.0253-3758.2014.12.002
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出版历程
  • 收稿日期:  2017-12-18
  • 刊出日期:  2018-03-30

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