去冷沉淀血浆的质量分析

Analysis of quality of cryoprecipitate-reduced plasma

目的比较去冷沉淀血浆(Cryoprecipitate-reduced plasma,CRP)中系列凝血因子、纤维蛋白原(Fibrinogen,Fib)和血管性血友病因子裂解蛋白酶(A disintegrin-like and metalloprotease with thrombospondin-1 repeats 13,ADAMTS-13)水平的变化。方法用140人份新鲜冰冻血浆(Fresh frozen plasma,FFP)制备CRP,采用Biggers一期法测定FFP和CRP中FⅡ、FⅤ、FⅦ、FⅧ、FⅨ、FⅩ、FⅪ、FⅫ的促凝活性;免疫比浊法测定Fib和血管性血友病因子抗原因子活动度(vWF∶Ag)水平;荧光共振能量转移法(Fluorescence resonance energy transfer,FRET)测定70人份FFP和CRP中的ADAMTS13活性及抗原含量。结果与FFP比较,CRP中FⅧ∶C、FⅤ∶C、FⅦ∶C、FⅨ∶C、FⅩ∶C、FⅪ∶C、Fib、vWF∶Ag水平均明显下降,且差异均有统计学意义(P<0.05或<0.001);FⅡ∶C、FⅫ∶C、ADAMTS13抗原含量和活性差异均无统计学意义(P>0.05)。结论 CRP可代替FFP用于血栓性血小板减少性紫癜(Thrombotic throm-bocytopenic purpura,TTP)的治疗,而不适用于FⅧ、Fib及vWF缺乏患者的补充治疗。

Objective To compare the levels of coagulation factors,fibrinogen（Fib） and Von Willebrand factor cleaving protease,a disintegrin-like and metalloprotease with thrombospondin-1 repeats 13（ADAMTS13）,in cryoprecipitate-reduced plasma（CRP）.Methods CRP was prepared with the fresh frozen plasma（FFP） from 140 donors.The coagulation-promoting activities of FⅡ,FⅣ,FⅦ,FⅧ,FⅨ,FⅩ,FⅪ and FⅫ in FFP and CRP were determined by one-stage Biggers method,while the activities of Fib and Von Willebrand factor antigen（vWF ∶ Ag） by immune turbidimetry.The activity and antigen contents of ADAMTS13 in FFP and CRP were determined by fluorescence resonance energy transfer（FRET） assay.Results As compared with those in FFP,the levels of FⅧ ∶ C,FⅤ ∶ C,FⅦ ∶ C,FⅨ ∶ C,FⅩ ∶ C,FⅪ ∶ C,Fib,vWF ∶ Ag decreased significantly（P 0.05 or P 0.001）,while the antigen content and activity of FⅡ ∶ C,FⅫ ∶ C and ADAMTS13 showed no significant difference（P 0.05）.Conclusion CRP may be used for treatment of thrombotic thrombocytopenic purpura（TTP） instead of CRP,while is unsuitable for complementary treatment of FⅧ,Fib and vWF deficiency.