Assessment of the efficacy of collagen-coated-bead columns for antiplatelet therapy in clinical settings

在这项研究中，我们评估了两种胶原包覆柱在血小板功能评估、抗血小板药物治疗效果和出血预测中的应用。特别是，通过测量血小板活性来诊断血栓性疾病患者是否具有耐药性，并在内镜活检前评估患者是否使用抗血小板药物。使用胶原包覆柱观察到健康人的血小板保留率有很大差异；这可能反映了个体差异，但不是方法的可变性。使用抗血小板药物和未使用抗血小板药物的患者保留率的重叠可能会限制目前测定系统中血小板功能参考区间的建立。然而，血小板潴留率可能反映了个体对抗血小板药物反应的差异性，可能有助于监测同一个体的抗血小板治疗效果。因此，在用药前后评估血小板功能对监测抗血小板药物的疗效具有重要意义。我们还采用透射式血小板聚集仪和筛滤压法全血聚集仪评估血小板功能。血小板功能测定是不可互换的，可能根据所使用的测定而变化。这些发现表明，血小板功能测定需要在合适的方法中使用，并对其临床效用进行评估。

In this study, we evaluated the utility of 2 types of collagen-coated-bead columns in the assessment of platelet function associated with the efficacy of antiplatelet drug therapy and prediction of bleeding. In particular, platelet activity was measured to diagnose whether patients with thrombotic disease were drug resistant and to assess patients who were or were not administered antiplatelet agents before endoscopic biopsy.Large variation in the platelet retention rate among healthy individuals was observed using the collagen-coated-bead column; this may reflect individual differences but not methodological variability. Overlapping of the retention rates of patients who were and were not administered the antiplatelet reagents may limit the establishment of reference intervals for platelet function in the present assay system. However, the platelet retention rate may reflect individual variability in response to the antiplatelet drugs and may be useful for monitoring the efficacy of antiplatelet therapy in the same individual. Thus, it is important to evaluate platelet function before and after medication for monitoring the effects of antiplatelet drugs. We also evaluated platelet function by using light-transmission platelet aggregometer and whole-blood aggregometer with a screen filtration pressure method. Platelet function assays are not interchangeable and may vary on the basis of the assay used. These findings suggest that the platelet function assay needs to be used in suitable methods and to be evaluated for additional verification of its clinical utility.