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对接受阿司匹林抗血小板作用的儿童进行血小板功能测试的分析
David M Newland1,2, Michelle M Palmer3,4, Lisa R Knorr3,4
1Department of Pharmacy, Seattle Children's Hospital, 4800 Sandpoint Way NE, Mailstop MB.5.420, Seattle, WA, 98105, USA. David.Newland@seattlechildrens.org.
Pediatric cardiology
|December 28, 2023
概括
在儿童中,阿司匹林耐药性很常见,在VerifyNow阿司匹林测试®上,值为500ARU,表明血栓形成风险较高. 这表明,550 ARU的切断值可能需要为儿科使用进行调整.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 药理学 药理学是指药理学的学科.
- 临床化学 临床化学
背景情况:
- 阿司匹林 (ASA) 是治疗儿科疾病的主要抗血小板治疗方法.
- 验证现在的阿司匹林测试 (VN) 测量了血小板对ASA的反应.
- 制造商指南将治疗效果定义为≤549阿司匹林反应单位 (ARU).
研究的目的:
- 评估儿童中ASA生化耐药性的发生率.
- 确定VN结果与血栓形成/出血事件之间的关联.
- 评估最佳的ARU切割值,以预测儿科患者的ASA耐药性.
主要方法:
- 对195名儿童 (<18岁) 进行初始VN测试 (2015-2020年) 的观察分析.
- 主要结局:患有ASA耐药性 (>549 ARU) 的患者比例.
- 二次结局:在113名接受ASA单疗的患者中,在6个月内发生血栓/出血事件的发生率.
主要成果:
- 在14.4%的儿童中检测到ASA生化耐药性.
- 经历了血栓事件的患者的平均VN结果显著更高 (516对465ARU).
- VN ASA结果≥500 ARU独立预测血栓形成风险增加 (p<0.01).
结论:
- 通过VerifyNow阿司匹林测试®,在儿科患者中确定了显著的ASA生化耐药性.
- 一个初始的VN ASA结果≥500 ARU,而不是≥550 ARU,与更高的血栓形成率有关.
- 在儿童中,ASA血小板抑制的确定的550 ARU切割值可能需要重新评估.
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