Platelet Aggregometry Testing: Molecular Mechanisms, Techniques and Clinical Implications.
Platelet Aggregometry Testing: Molecular Mechanisms, Techniques and Clinical Implications.
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DOI：
10.3390/ijms18081803
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发表时间：
2017-08-18
影响因子：
5.6
通讯作者：
Toth K
中科院分区：
文献类型：
--
作者：
Koltai K;Kesmarky G;Feher G;Tibold A;Toth K
血小板在正常止血中起着重要作用，而其遗传或获得性功能障碍与各种出血性疾病或血栓形成事件有关。目前有几种实验室方法或护理点检测方法可用于临床和实验环境。这些方法基于血小板聚集性、血小板粘附性、凝块形成过程中的粘弹性、血栓素代谢的评估或某些流式细胞术技术，描述了血小板功能的不同方面。血小板聚集性测定在不同的临床环境中被用于监测抗血小板治疗的反应，评估围手术期出血的风险，诊断遗传性出血疾病或用于输血医学。血小板功能驱动型抗血小板治疗的理论基础是基于对接受经皮冠状动脉介入治疗(PCI)的患者的几项研究的结果，在这些研究中，尽管P2Y12被抑制，但血小板的高反应性与支架血栓形成或心血管死亡等缺血性事件之间存在关联。然而，最近的大规模随机对照试验始终未能证明基于血小板功能检测的个体化抗血小板治疗的好处。
Platelets play a fundamental role in normal hemostasis, while their inherited or acquired dysfunctions are involved in a variety of bleeding disorders or thrombotic events. Several laboratory methodologies or point-of-care testing methods are currently available for clinical and experimental settings. These methods describe different aspects of platelet function based on platelet aggregation, platelet adhesion, the viscoelastic properties during clot formation, the evaluation of thromboxane metabolism or certain flow cytometry techniques. Platelet aggregometry is applied in different clinical settings as monitoring response to antiplatelet therapies, the assessment of perioperative bleeding risk, the diagnosis of inherited bleeding disorders or in transfusion medicine. The rationale for platelet function-driven antiplatelet therapy was based on the result of several studies on patients undergoing percutaneous coronary intervention (PCI), where an association between high platelet reactivity despite P2Y12 inhibition and ischemic events as stent thrombosis or cardiovascular death was found. However, recent large scale randomized, controlled trials have consistently failed to demonstrate a benefit of personalised antiplatelet therapy based on platelet function testing.
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