影响薄片法血小板聚集实验的因素

Factors affecting slide platelet aggregation test time

目的:研究常见影响因素对薄片法血小板聚集实验(SPAT)时间的影响.方法:测定下列富含血小板血浆(PRP)的SPAT:①调整血小板计数分别为240,120,60,30和15×109/L的8例健康献血者PRP;②分别在40,35,30,25,20,15,10和5℃条件下恒温30min的10例健康献血者PRP;③含终浓度为0,10,20,30,40和50g/L的二甲基亚砜(DMSO)并室温放置30min的10例健康献血者PRP;④在室温放置1,2,3,4h后的8例健康志愿者服用阿司匹林前后PRP;⑤含浓度分别为0,0.5,1.0,2.0和3.0U/L的肝素或0.1g/LEDTA的8例健康献血者PRP.结果:①随着血小板计数的降低,SPAT时间逐渐延长;同一供者血小板计数与其SPAT时间呈显著的直线负相关(r=0.996,P=0.004);②温度在20～40℃对SPAT时间无明显影响,但当温度低于20℃时SPAT时间明显延长;③DMSO对SPAT有明显的影响,使SPAT时间明显延长,并呈明显的剂量效应;④血小板标本室温放置1,2,3和4hSPAT无显著差异(P=0.815);⑤肝素对SPAT时间无明显影响,而0.1g/L乙二胺四乙酸(EDTA)可完全抑制血小板聚集.结论:血小板计数、所处的温度以及含有DMSO时,均能在一定程度上影响SPAT时间,但是上述因素均不影响血小板最终形成肉眼可见的聚集,且聚集时间仍然在180s以内.

AIM： To explore the factors which affect the slide platelet aggregation test （SPAT） time. METHODS：The SPAT of the following platelet rich plasma （PRP） wastested： ① PRP and the gradient diluted samples from eight healthy blood donors. ② Ten healthy blood donors＇ PRP treated respectively at 40, 35, 30, 25, 20, 15, 10 and 5 degrees centigrade for thirty minutes. ③ Ten healthy blood donors＇ PRP treated respectively with 0, 1, 2, 3, 4 and 5 percent dimethyl sulphoxide for thirty minutes.④ PRP of eight volunteers before and after a three-day administration of ASA in a dose of 100 mg/day stored at room temperature for 1,2, 3 and 4 hours respectively.⑤ PRP of eight healthy donors with 0, 0.5, 1.0, 2.0 and 3.0 U/L heparin or EDTA respectively. RESULTS： ① The SPAT time was prolonged when the platelet count decreased and they had a significant linear relationship （r=0.996, P=0.004）. ② No significant difference in SPAT time was detected when the PRP was stored at the temperature ranging from 20 to 40 degrees Centigrade, but significant delay was detected when the storage temperature was below 20 degrees Centigrade. ③A significant dose dependent delay effect on SPAT was detected when dimethyl sulfoxide （DMSO） was added into PRP. ④ No significant difference of SPAT was detected when PRP was stored at room temperature for four hours （P = 0. 815）. ⑤ No significant difference of SPAT was detected when hepann was added as anticoagulant and 0.1 g/L EDTA inhibited the platelet aggregation completely. CONCLUSION： The platelet count, the platelet storing temperature and the DMSO content in platelets will to some extent delay the SPAT time but they will not inhibit the platelet aggregation, with the SPAT time still within 180 seconds.