标本放置时间对PL-11检测血小板功能的影响

Effects of sample storage time on platelet function tested with PL-11 analyzer

目的探讨标本在室温保存时,不同放置时间对血小板功能检测仪PL-11结果的影响。方法采集我院2012级学员队20位健康学员及2013年我院门诊20位服用氯毗格雷和阿司匹林的冠心病患者肘静脉构橼酸钠抗凝全血,应用PL-11分别在采血后不同保存时间点(2 h、4h、8h)测定不同血小板活化诱导剂诱导的血小板聚集率。结果健康组:以花生四烯酸(arachidonic acid,AA)为血小板活化诱导剂时,2h、4h、8h的放置时间对血小板聚集功能未产生影响(P>0.05);二磷酸腺苷(adenosine di-phosphate,ADP)为诱导剂时,血小板聚集率在4h明显降低(P<0.01),8h时已经降低至4.3%(P<0.01);胶原(collagen,Col)诱导的血小板聚集率在采血后4h时较2h明显降低(P<0.01),但与8h差异无统计学意义(P>0.05)。服用抗血小板药物组:AA诱导的血小板聚集率2h、4h、8h两两差异均无统计学意义(P>0.05),ADP诱导的血小板聚集率在4h时明显降低(P<0.01),4h与8h差异无统计学意义(P>0.05),Col诱导的血小板聚集率在8h后出现明显降低(P<0.01)。结论构橼酸盐抗凝血标本采集后放置时间对PL-11血小板功能检测存在影响,在检测健康人组或已服用双联抗血小板药物患者组时,AA诱导血小板聚集受时间影响较小,ADP与胶原诱导血小板聚集时随着标本放置时间延长,血小板聚集率降低。结合凝血功能检测对构橼酸盐抗凝血的要求,PL-11检测血小板功能时,AA诱导聚集可在采血后4h内完成,ADP与胶原诱导应在采血后2h内完成。

Objective To identify the effects of storage time on platelet function tested with PL-11 analyzer under room temperature. Methods Citrated antecubital vein blood samples of graduate students in grade 2012 of Chinese PLA Medical School （n=20） and coronary heart disease （CHD） outpatients （n=20） treated with dual-antiplatelet drugs in the department of cardiology were drawn and tested by PL-11 analyzer at 3 testing points： 2, 4 and 8 hours after blooding. The maximum platelet aggregation ratio was tested with 3 different activators： arachidonic acid （AA）, adenosine di-phosphate （ADP） and collagen. Results Healthy young men： AA-induced platelet aggregation ratio showed no difference between 2 h, 4 h and 8 h （P 〉 0.05）. When ADP used as the activator, platelet aggregation ratio reduced apparently at 4 h compared with 2 h （P 〈 0.01）, and it reduced to 4.3% at 8 h （P 〈 0.01）. There was a clear reduction of collagen-induced platelet aggregation at 4 h compared with 2 h （P 〈 0.01）, while no difference was found between 4 h and 8 h （P 〉 0.05）. Patients treated with dual-antiplatelet drugs： AA-induced results showed no statistic difference between 2 h, 4 h and 8 h （P 〉 0.05）. ADP-induced results showed an obvious reduction at 4 h, while no difference was found between 4 h and 8 h （P 〉 0.05）. Collagen-induced aggregation ratio reduced apparently at 8 h after blood sampling （P 〈 0.01）. Conclusion Storage time affects the results of PL-11 platelet function test with limited influence on AA-induced platelet aggregation ratio, whatever in healthy men or patients treated with dual-antiplatelet drugs. ADP- or collagen-induced platelet aggregation ratio reduces as the time delay extending. The time delay between collection, transport and analysis should ideally be preferable in 4 hours when AA used as activator or 2 hours when ADP and collagen used as activators.