A few days ago, an old patient with coronary heart disease asked me a question: 'Doctor, I heard that I could do a 'platelet function test' so that I can know which anti-platelet drugs I use are right. You said I don't need to use it. Measure it? 'I answered him clearly and it is not necessary. In recent years, many hospitals have carried out a platelet function test program. Doctors began to select antiplatelet drugs for patients based on the test results. This approach seems reasonable: since the test results show the patient If the drug is not sensitive or resistant to certain antiplatelet drugs, it is not appropriate to use this drug again. The doctor's original intention is good, but the actual situation is not satisfactory.
At present, the mainstream clinical practice guidelines issued by authoritative domestic and foreign academic institutions do not recommend the use of platelet function tests (including genetic tests) to guide the selection of antiplatelet drugs. If this test is really of clinical importance, why these authorities The guideline is not recommended? One of the main reasons is that due to the limitations of technology, the detection method is still not closed.
Last year, a study showed that four different detection techniques were used to evaluate platelet function, and four completely different conclusions were drawn. In 17% of patients, even in the 'platelet reactivity' indicator, different detection methods were used to measure The diametrically opposite results. This shows that at least at this stage, platelet testing is very unreliable and cannot guide clinical drug use. The inhibitory effect of antiplatelet drugs on platelets is complicated by multiple factors, and it is difficult to accurately pass several test parameters. Predicting the efficacy of drugs. Therefore, to check the platelet function can not only help to formulate a more accurate treatment plan, but also increase the patient's economic burden. At least at this stage, it is not necessary to do it. The patient who did the examination uses the result as a reference. That's it. Of course, with the continuous improvement of detection technology, this may be a very meaningful inspection in the future.
