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首页> 外文期刊>Platelets >Clinical utility of remote platelet function measurement using P-selectin: assessment of aspirin, clopidogrel, and prasugrel and bleeding disorders
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Clinical utility of remote platelet function measurement using P-selectin: assessment of aspirin, clopidogrel, and prasugrel and bleeding disorders

机译：使用P-Selectin的远程血小板函数测量的临床效用：阿司匹林，氯吡格雷和普拉布雷和出血障碍的评估

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摘要

Vascular diseases such as myocardial infarction and ischemic stroke are associated with increased platelet function whilst the risk of recurrence is reduced by antiplatelet agents such as aspirin, clopidogrel, and prasugrel. However, some patients exhibit high platelet reactivity, especially with clopidogrel. Existing platelet function tests may not be ideal in that they can be expensive, are often time consuming, and measurements must be made near to the patient and within a few hours of blood collection. Platelet activation leads to translocation of P-selectin from alpha-granules to the cell surface. Following activation with arachidonic acid (which is blocked by aspirin) or adenosine diphosphate (inhibited by clopidogrel) and fixation, samples may be stored or posted to a laboratory performing flow cytometric quantification of platelet P-selectin expression. Acute myocardial infarction and ischemic stroke are associated with high platelet reactivity on clopidogrel in 6-58% of patients when assessed with P-selectin expression, and high reactivity was associated with an increased risk of recurrence after myocardial infarction. Use of P-selectin expression tests may also be of relevance to surgical and veterinary practice and the diagnosis of mild bleeding disorders. The present review explores this topic in further detail.
机译：心肌梗死和缺血性中风等血管疾病与血小板功能增加有关，而阿司匹林、氯吡格雷和普拉格雷等抗血小板药物可降低复发风险。然而，一些患者表现出较高的血小板反应性，尤其是氯吡格雷。现有的血小板功能检测可能并不理想，因为它们可能很昂贵，通常很耗时，而且必须在患者附近和采血后几个小时内进行测量。血小板活化导致P-选择素从α颗粒转移到细胞表面。在用花生四烯酸（被阿司匹林阻断）或二磷酸腺苷（被氯吡格雷抑制）激活并固定后，可将样本储存或邮寄至实验室，以进行血小板P-选择素表达的流式细胞术定量。通过P-选择素表达评估，6-58%的患者中，急性心肌梗死和缺血性卒中与氯吡格雷的高血小板反应性相关，高反应性与心肌梗死后复发风险增加相关。P-选择素表达检测的使用也可能与外科和兽医实践以及轻度出血性疾病的诊断有关。本综述将进一步详细探讨这一主题。

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