献血者凝血状态对其捐献的单采血小板体外聚集现象的影响

Influence of blood donors′coagulation status in apheresis platelet aggregation in vitro

目的探讨血小板捐献者自身凝血状态对机器采集的血小板体外聚集现象是否有影响。方法设血小板体外聚集实验组(简称实验组):选择既往以AMICUS血细胞分离机采集单采血小板并曾发生血小板体外聚集现象≥3次,且最后1次发生在其最近1次捐献单采血小板时的献血者30名作为研究对象;对照组:选择既往以AMICUS血细胞分离机采集单采血小板数≥3次并从未发生血小板体外聚集现象的献血者30名作为研究对象。实验开始(此次单采血小板)前,2组对象均使用全自动血液细胞分析仪(BC-3000Plus)检测外周血Plt、MPV、PDW、Pct、P-LCR等血小板基本参数,使用血栓弹力图(TEG)仪检测凝血反应时间(R)、凝血形成时间(K)、凝血速率(α)、最大血凝块强度(MA)、凝血指数(CI)等TEG参数。应用SPSS24.0统计软件,采用t检验分析比较2组检测参数的差异。结果实验与对照组除CI为0.48±1.00 vs-0.99±1.96(P<0.05)外,所有血小板基本参数及其他TEG参数比较无明显差异(P>0.05)。结论献血者自身凝血状态可能是引发其单采血小板出现体外聚集现象的独立风险因素。

Objective To investigate whether the blood donors’coagulation status may lead to apheresis platelet aggregation in vitro.Methods Thirty blood donors with aggregation in apheresis platelets collected by AMICUS blood cell separator no less than 3 times previously and occurred when the last time of apheresis donation were observed in aggregated group(referred to as the experimental group);Thirty donors without aggregation in apheresis platelets collected by AMICUS blood cell separator no less than 3 times were observed in the control group simultaneously.The basic platelet parameters in the two groups,including Plt,MPV,PDW,Pct,P-LCR were detected by automatic blood cell analyzer(BC-3000Plus),and thromboelastogram indexes including reaction time(R),kinetics time(K),kinetics of clot development(α),maximum amplitude(MA)and coagulation index(CI)were tested by Thrombosis elastography(TEG)before collection.With SPSS24.0 software,t test was used to compare the differences between the two groups.Results The CI value in experimental group was significantly different from that of the control group(0.48±1.00 vs-0.99±1.96,P<0.05),and there was no significant difference in all above basic platelet parameters and other TEG parameters(P>0.05).Conclusion The coagulation status of blood donors may be an independent risk factor for the in vitro aggregation of apheresis platelets.