TEG技术在血小板保存过程中功能评价的应用研究  

Application of Thrombelastography in Evaluation of Platelet Function during Storage

作　　者：于洋[1] 林子林[1] 冯倩[1] 潘纪春[1] 张婷[1] 孙桂香[1] 张小娟[1] 马春娅[1] 葛国峰[1] 汪德清[1] 骆群[1] 田亚平[1] 

机构地区：[1]解放军总医院输血科,解放军临床输血中心,北京100853

出　　处：《中国实验血液学杂志》2008年第4期926-929,共4页Journal of Experimental Hematology

摘　　要：本研究旨在通过血栓弹力图(thrombelastography,TEG)技术探讨血小板保存过程中功能的变化。随机选择各项指标均符合国家标准的单供者机采血小板12个单位并在(22±2)℃条件下振荡保存。分别在保存1、2、3、4、5天检测血栓弹力图参数,包括反应时间(R)、凝血时间(K)、α角(ANG)和最大振幅(MA),同时检测血小板计数、平均血小板体积、低渗休克反应(HSR)水平、CD62p阳性率及凝血酶激活CD62p再表达率的变化,综合评价血小板保存过程中体外功能的变化情况。结果显示:平均血小板体积随保存时间延长而轻度增大,但无统计学差异(p>0.05);血小板膜表面CD62p表达率随保存时间延长而显著升高(p<0.01);凝血酶激活后CD62p再表达率随保存时间的延长而显著下降(p<0.01);血小板低渗休克反应水平在1-5天无明显变化(p>0.05);R值随保存时间延长而明显延长(p<0.01),K值无明显变化(p>0.05),α角虽呈轻度下降趋势,但无显著差异(p>0.05);MA值在保存1-4天无显著变化,保存5天时仅有轻度下降(p<0.05)。结论:虽然血小板随保存时间延长激活率明显升高,但反映血小板综合凝血功能的最大振幅(MA值)和HSR水平在整个保存期内并无显著变化,说明保存期末的血小板仍然具有良好的止血功能;血栓弹力图参数MA值可以作为一项重要指标用于血小板保存过程中的功能评价。This study was aimed to explore changes of platelet function in vitro during storage by thrombelastography （TEG）. 12 units plateletpheresis were randomly selected and stored at 20 to 24℃ with agitation. Thrombelastography variable parameters R,K values and maximal amplitude （MA） were measured on 1,2,3,4,5 days of platelet storage. Platelet concentration, mean platelet volume（ MPV）, hypotonic shock response （HSR） , CD62p expression and CD62p reexpression on platelet surface were detected at the same time. Changes of platelet function in virto were systematically evaluated by above-mentioned indexes. The results showed that MPV augmented slightly with prolongation of preserved time（p 〉 0.05 ）, and CD62p expression on platelet surface increased remarkably（p 〈 0.01 ）, while CD62p reexpression decreased gradually（p 〈 0.01 ）. There were no significant differences in HSR level of platelets during storage （p 〉 0. 05）. R value increased with prolongation of preserved time（p 〈 0.01 ）. There were no obvious changes on K value and αAngle during storage （p〉0.05）. There were no obvious changes in MA from 1 to 4 days, and MA decreased slightly on day 5 （p 〈 0.05 ）. It is concluded that there was no significant change in MA and HSR which reflects comprehensive coagulation of platelets during storage. Platelets on the end of storage have excellent function of hemostasis; Thrombelastography parameter MA value can be used as a valuable indicator for evaluation of platelet function in vitro during storage.

关 键 词：血栓弹力图 血小板保存 低渗休克反应 CD62P 

分 类 号：R457.1[医药卫生—治疗学] R331.143[医药卫生—临床医学]