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在接受血管外科手术的患者中,随着时间的推移,外科手术期间的血小板活性:一项观察性试点研究
A R T Brand Kanters1, N C Roozendaal1, N M J Parr2
1Department of Vascular Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
经过心血管内关节切除术 (CEA) 的患者的血小板反应性随着时间的推移而大幅波动,使目前的监测方法无法用于指导抗血小板治疗 (APT). 个体对APT的反应各不相同,影响治疗的有效性.
科学领域:
- 心血管医学 心血管医学
- 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:
- 血管疾病患者接受抗血小板治疗 (APT) 后再血管化面临高血栓形成风险.
- 对APT的个体反应有所不同,高治疗血小板反应率 (HTPR) 影响高达40%的患者.
- 了解血小板反应的时间变化对于优化APT至关重要.
研究的目的:
- 为了研究随着时间的推移在用克洛皮多格雷尔治疗的 carotid endarterectomy (CEA) 接受治疗的患者中残余血小板活性的变化.
主要方法:
- 一项前性,单中心的观察性研究,涉及50名接受CEA的患者.
- 使用VerifyNow,VASP测定和PACT进行术前评估的血小板活性.
- 对CYP2C19多态的基因定型,以确定克洛皮多格雷尔代谢剂的状态.
主要成果:
- 验证现在和VASP测试显示了血小板反应性随着时间的推移显著变化 (p < .001和p = .029,分别).
- PACT测定没有显示出显著的时间变化.
- 个人患者的HTPR状态随着时间的推移而变化,特别是在八周后使用VASP时 (p = .018).
结论:
- 在CEA患者中,外科手术期间的血小板反应性测量是可变的,并且在测量之间显示出差的一致性.
- HTPR状态的动态性质表明当前的术后监测可能对调整APT不可靠.
- 需要进一步的研究来确定监测血小板活性的最佳时间和方法,以有效指导APT.
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