Fortschritte in der Thrombozytenfunktionsdiagnostik

Summary

Both for diagnosis of congenital and acquired platelet dysfunction as well as for therapy monitoring after application of platelet function inhibitors various methods have been established for evaluation of platelet function. In contrast to the gold standard of platelet function testing, the light transmission aggregometry in platelet rich plasma the Point-of-care (POC) analyzers allow fast analysis of platelet function without extensive laboratory work up. The conditions of the pre-analytical phase, however, are still of enormous importance in the prevention of medical errors. There is increasing clinical data in monitoring the effect of platelet aggregation inhibitors, showing that quantitative determination of the platelet function degree correlates with risk of increased bleeding or stent thrombosis. However, it is still unclear, which is the optimal test system, to predict the clinical outcome of these patients.

Zusammenfassung

Zur Diagnose angeborener oder erworbener Thrombozytenfunktionsstörungen und zur Therapiekontrolle nach pharmakologischer Intervention haben sich in den vergangenen Jahren vermehrt Verfahren zur Evaluation der Thrombozytenfunktion etabliert. Im Gegensatz zu der aufwändigen Born-Lichttrans -missionsaggregometrie, dem Goldstandard der Thrombozytenfunktionsdiagnostik, erlauben Point-of-care(POC)-Verfahren eine zeitnahe Analyse der Thrombozytenfunktion auch ohne umfangreiche labormedizinische Erfahrung. Die Bedingungen der präanalytischen Phase sind dennoch von enormer Wichtigkeit zur Vermeidung medizinischer Fehlentscheidungen. In Bezug auf das Monitoring der Wirkung von Thrombozytenaggregationshemmer gibt es zunehmend Studiendaten, die zeigen, dass durch quantitative Bestimmung des Ausmaßes der Thrombozytenaggregations -hemmung Patienten mit erhöhtem Blutungsbzw. Stentthromboserisiko identifiziert werden können. Noch unklar ist das optimale Testsystem, mit dem das klinische Outcome dieser Patienten durch individualisierte Therapie verbessert werden kann.

Keywords

Platelet dysfunction - monitoring of platelet function - pre-analytic - POC systems

Schlüsselwörter

Thrombozytenfunktionsstörungen - Monitorin - Präanalytik - POC-Systeme

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