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使用TEG凝血测试预测PAD患者抗血小板药物的出血风险

Adriana A Rodriguez Alvarez1, Isabella Ferlini Cieri1, Mounika Boya1

  • 1Division of Vascular and Endovascular Surgery, Massachusetts General Hospital, Boston, MA 02114 USA.

Journal of surgery and research
|August 20, 2025
PubMed
概括

通过血小板测绘 (TEG- PM) 测量的高血小板抑制和低最大幅度的腺二酸盐可以预测在接受抗血小板治疗的外周动脉疾病 (PAD) 患者的出血风险.

科学领域:

  • 心血管医学
  • 血液学
  • 外科研究

背景情况:

  • 血流是抗血栓治疗的一个重要并发症.
  • 血小板测绘 (TEG- PM) 对外周动脉疾病 (PAD) 出血风险的预测价值尚未得到充分证实.
  • 在PAD中目前的抗血栓治疗可能受益于改进的风险分层工具.

研究的目的:

  • 评估TEG- PM参数的有用性,特别是血小板抑制 (PI) 和MA ADP,用于预测经过下肢再血管化的PAD患者的出血风险.
  • 确定PI和MAADP的最佳切割值,以确定患有出血风险增加的患者.

主要方法:

  • 在一年的随访期内对234名PAD患者进行下肢再血管化.
  • 被定义为需要干预或输血的临床显著出血.
  • 使用TEG- PM评估血小板功能,使用曼- 惠特尼U和ROC分析来比较群体并确定预测值.

主要成果:

  • 14% 的患者经历出血事件.
  • 患有出血事件的患者显示显著更高的PI (94. 5% 与 24. 1%) 和较低的MA ADP (22. 4 与 52).
  • 在ROC分析中,PI> 86. 4% (AUC: 0. 89) 和MA ADP< 31. 9 (AUC: 0. 85) 是出血风险的显著预测因素.
关键词:
抗血小板治疗出血的风险发生出血周围动脉疾病血小板功能检测重新血管化血小板造影

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结论:

  • 血小板抑制升高和MA ADP水平降低与PAD患者的出血风险增加有关.
  • 在PAD中,TEG-PM参数可以作为个性化抗血栓治疗的有价值生物标志物.
  • 这些发现表明TEG- PM可以帮助分层出血风险并优化PAD的抗血小板治疗.