血栓弹力图在单采血小板出凝血功能监测中的应用研究  

Application of the thrombelastogram in the evaluation of coagulation functions pre/post plateletpheresis

作　　者：冯晴[1] 吴乾波 俞丽[1] 郑悦[1] 李春燕[1] 孔福仙[1] 

机构地区：[1]浙江省血液中心,浙江杭州310006

出　　处：《中国输血杂志》2017年第12期1346-1348,共3页Chinese Journal of Blood Transfusion

基　　金：浙江省医药卫生科技计划基金(2015KYA068)

摘　　要：目的运用血栓弹力图仪(TEG)对单采献血者血小板采集前后的出凝血功能进行系统性评价。方法选取2015年12月-2016年11月期间的150名单采献血者,采用TEG对血小板单采前后的出凝血情况进行监测,并根据血小板采集量(1.0 U、1.5 U、2.0 U)、抗凝剂使用量(<300 mL、300-400 mL、>400 mL)进行分组。比对3组献血者血小板采集前后TEG各项参数的变化,评估献血者单采过程中凝血功能的变化及相关影响因素。结果献血者血小板采集前后R时间分别为(7.04±1.49)min和(7.40±1.35)min,K时间分别为(2.19±0.48)min和(2.36±0.49)min,Angle分别为(60.79±5.14)°和(58.84±5.44)°,MA分别为(61.52±3.82)mm和(58.67±3.52)mm,CI分别为-1.02±1.72和-1.78±1.57,采集前后R、K、Angle、MA、CI均在正常范围,各指标采集前后比较均有统计学意义(P<0.001);3组不同采集量和不同抗凝剂使用量的献血者采集前后TEG指标比较均有统计学意义(P<0.05)。结论TEG监测可以动态、全面地监测单采血小板过程中献血者出凝血功能的变化,献血者单采前后TEG指标有波动,但仍在机体正常的范围内,血小板单采对献血者凝血功能影响在安全可控范围内。Objective To evaluate coagulation functions in apheresis donors and to predict the potential risk of hemorrhage or thrombosis during apheresis with the collected data by the thrombelastogram（ TEG）. Methods The TEG were analyzed to evaluate coagulation function before and after platelet apheresis,which was performed on 150 donors during Dec.2015-Nov.2016. All cases were divided into 3 by 2 groups based on the collected platelet volume（ 1. 0 U、1. 5 U、2. 0 U） or the anticoagulant dose（ 300 mL、300-400 mL、400 mL）. The results were compared among three groups. Results The R times before and after plateletpheresis were 7. 04±1. 49 min vs 7. 40±1. 35 min,the K times were 2. 19±0. 48 min vs 2. 36±0. 49 min,the angles were 60. 79± 5. 14° vs 58. 84 ± 5. 44°,MA were 61. 52 ± 3. 82 mm vs 58. 67 ± 3. 52 mm and CI were-1. 02±1. 72 vs-1. 78± 1. 57. All TEG index before and after plateletpheresis were within the normal range with significant difference（ P〈0. 001） as well as the in-group comparison among the platelet volume group and the anticoagulant dose group（ P〉0. 05）. Conclusion TEG can dynamically and thoroughly reflect the entire process of coagulation during apheresis.TEG indexes fluctuates before and after plateletpheresis,but within a normal range. The blood coagulation function of donors experiencing plateletpheresis remains in a safe range and the process is controllable.

关 键 词：血栓弹力图 出凝血功能 单采血小板 

分 类 号：R446.111[医药卫生—诊断学]