在儿童患者中检测阿司匹林耐药性的发生率和方法
Hansamon Poparn1,2, Yaowaree Kittikalayawong1,2, Piti Techavichit1,2
1Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand.
Pediatric health, medicine and therapeutics
|November 19, 2024
概括
抗阿司匹林在泰国儿童中不常见,仅影响2.7%的儿童. 不建议进行常规查,但在特定情况下,PFA-200等临床检查可能有所帮助.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 血液学 血液学 血液学
- 临床药理学 临床药理学
背景情况:
- 抗阿司匹林可以导致严重的并发症,如心肌梗塞或中风,特别是在儿童中.
- 尽管它具有临床意义,但在儿科患者中评估阿司匹林耐药性是罕见的.
- 标准聚合度是耗时的,需要评估快速的 point-of-care 替代方案.
研究的目的:
- 为了确定泰国儿童中阿司匹林耐药性的发生率.
- 为了比较治疗点血小板功能分析仪 (PFA-200) 和出血时间 (BT) 测试与标准阻抗聚合计 (IA) 的疗效.
- 评估小儿科患者常规抗阿司匹林查的作用.
主要方法:
- 一个单中心的横截面研究,涉及37名泰国儿童 (≤15岁) 接受阿司匹林治疗.
- 血小板功能分析仪 (PFA-200) 和床边出血时间 (BT) 与标准全血阻抗聚合计 (IA) 的比较.
- 阿司匹林耐药性定义为IA (>5欧姆),PFA-200 (<180秒) 和BT (≤7分钟).
主要成果:
- 通过IA,阿司匹林耐药性在2.7%的儿科患者中得到证实.
- PFA-200表现出100%的灵敏度和83.3%的特异性,表现优于BT (36.1%的特异性).
- PFA-200和BT与IA的一致性较差 (麦克纳马P<0.05,卡帕值0.215和0.030).
结论:
- 泰国儿童中抗阿司匹林的情况很少见.
- 通常不建议对阿司匹林耐药性进行常规查;考虑是否出现复发性血栓形成或耐药性风险因素.
- PFA-200显示出作为小儿阿司匹林耐药性的临床查工具的潜力,与床边BT不同.
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