血小板单采活化及个体差异  

Platelet apheresis activation and individual differences

作　　者：张开文[1] 潘洁[1] 杨文萍[1] 黄道斌[1] 李丽娜 许亚亚 陈琪[2] ZHANG Kaiwen;PAN Jie;YANG Wenping;HUANG Daobin;LI Lina;XU Yaya;CHEN Qi(Taizhou Central Blood Station,Taizhou,318000,China;Taizhou Central Hospital)

机构地区：[1]台州市中心血站,浙江台州318000 [2]台州市中心医院

出　　处：《临床血液学杂志》2022年第10期735-738,743,共5页Journal of Clinical Hematology

基　　金：台州市科学技术局项目(No:20ywa62)。

摘　　要：目的:研究认识血小板单采活化的特点,分析单采血小板活化的相关因素,识别验证对单采过程诱导活化敏感个体,合理处置,减少血小板输注无效(PTR)发生频率。方法:随机收集台州市中心血站的单采血小板样本,在下机后30min内用PAC-1、CD62p荧光抗体标记并用1%甲醛固定,随后及时上机检测活化百分率,同时收集该样本对应献血者的体检、献血前筛查、单采数据。对收集的各类数据进行相应的统计分析。结果:PAC-1、CD62p阳性表达率分别为(35.3±23.5)%、(2.7±2.9)%,两者配对t检验统计分析显示两者的差异有统计学意义(t=18.853,P<0.01);相关分析显示,PAC-1、CD62p的阳性表达率分别与HGB和HCT呈负相关(r=-0.257,P=0.001;r=-0.177,P=0.021;r=-0.262,P=0.001;r=-0.187,P=0.015),与献血者年龄呈正相关(r=0.237,P=0.002;r=0.242,P=0.002);以献血者为自变量、PAC-1阳性表达率为因变量的单因素方差分析,差异有统计学意义。结论:单采活化是以GPⅡbⅢa构象改变暴露出纤维蛋白原结合位点为特征的血小板早期活化形式为主,而α颗粒膜融合表达CD62p的晚期活化则处于较低的水平,且这2种活化形式存在正相关关系(r=0.503,P<0.01);与活化百分率相关指标可以为献血者的筛查及单采血小板产品的合理处置提供参考;血小板单采PAC-1阳性表达存在个体差异,是献血者固有的血小板反应特性。Objective:To study and understand the characteristics of platelet apheresis activation,analyze the related factors of platelet activation during apheresis,identify and verify individuals who were sensitive to activa-tion induced by apheresis,and handle them rationally to reduce the frequency of platelet transfusion failure(PTR).Methods:Apheresis platelet samples from this station were randomly collected,labeled with PAC-1and CD62p fluorescent antibodies and fixed with 1%formaldehyde within half an hour after getting off the machine,and then the activation percentage was detected on the machine in time,and the medical examination data,pre-donation screening data and apheresis data of the blood donors corresponding to the samples was collected.The collected da-ta was statistically analyzed.Results:The positive expression rates of PAC-1and CD62p were(35.3±23.5)%and(2.7±2.9)%,respectively.The paired t-test statistical analysis showed that the difference was statistically significant(t=18.853,P<0.01);correlation analysis showed that the positive expression rates of PAC-1and CD62p were negatively correlated with HGB and HCT,respectively(r=-0.257,P=0.001;r=-0.177,P=0.021;r=-0.262,P=0.001;r=-0.187,P=0.015),positively correlated with the age of blood donors(r=0.237,P=0.002;r=0.242,P=0.002);one-way ANOVA with blood donors as the independent variable PAC-1positive expression rate as the dependent variable.It was statistically significant.Conclusion:Apheresis ac-tivation is mainly the early activation form of platelets characterized by the conformational change of GPⅡbⅢa exposing the fibrinogen binding site,while the late activation ofα-granule membrane fusion expressing CD62p is at a lower level,and there is a positive correlation between the two activation forms(r=0.503,P<0.01);the index related to the activation percentage can be used for the screening of blood donors and provide reference for the rea-sonable disposal of apheresis platelet product.There were individual differences in the positive expression of PAC-

关 键 词：单采血小板 血小板活化 相关因素 个体差异 

分 类 号：R457.1[医药卫生—治疗学]