Effects of lornoxicam combining with fentanyl on postoperative arrhythmia and platelet function in patients with coronary artery disease after abdominal surgery

To investigate the effects of patient-controlled intravenous analgesia (PCIA) with lornoxicam and fentanyl on arrhythmia and the expression of platelet membrane glycoproteins in patients with coronary artery disease (CAD) after abdominal surgery.Methods Eighty ASA Ⅱ or Ⅲ patients with CAD aged 51～66 yrs weighing 59～68 kg presenting for abdominal surgery participated in this study.CAD was diagnosed by clinical symptoms and ischemic changes on ECG.The patients were premedicated with intramuscular henobarbital 0.1 g and scopolamine 0.3 mg.Anesthesia was induced with fentanyl,droperidol,propofol and vecuronium and maintained with propofol,fentanyl and vecuronium.The patients received PCIA after operation.The PCIA solution contained fentanyl 0.9 mg and droperidol 5 mg in 100 ml of normal saline (N.S.) in group A (n=40) or lornoxicam 56 mg,fentanyl 0.2 mg and droperidol 5 mg in 100 ml N.S. in group B (n=40).In group A the loading dose was fentanyl 0.05 mg and group B lornoxicam 4 mg.PCIA included a background infusion at 2 ml·h -1 and a bolus of 0.5 ml with a 15 min lock-out.VAS(0=no pain,10= worst pain) was used to measure pain intensity.In addition to BP,HR and SpO2 monitoring ECG was continuously monitored with a Holter monitor after operation.Blood samples were taken from peripheral vein before and 6 h after operation and on the 1st,2nd,7th and 8th postoperative days for determination of the expression of CD 62p ,CD 63 and CD 41 /CD 61 on the platelet membrane,platelet count,prothrombin time (PT) thrombin time (TT) and partial thromboplastin time (PTT).Results The two groups were comparable with respect to sex,age,body weight,severity of CAD,duration of operation and intraoperative blood loss.The patients received no blood transfusion during operation.There was no significant difference in VAS score,platelet count,PT,TT and PTT between the two groups.The incidence of atrial and ventricular premature beat on ECG and the expression of CD 41 /CD 61 ,CD 62p and CD 63 on the platelet membrane were significantly lower in group B than in group A on the 7th and 8th postoperative days(P<0.05 or 0.01).Conclusion Postoperative PCIA with lornoxicam and fentanyl can more effectively reduce the incidence of postoperative arrhythmia in patients with CAD.Suppression of activation of platelets by lornoxicam may contribute to the mechanism.10 refs,3 tabs.

Impact of high dose vitamin C on platelet function

AIM To examine the effect of high doses of vitamin C(VitC) on ex vivo human platelets(PLTs).METHODS Platelet concentrates collected for therapeutic or prophylactic transfusions were exposed to:(1) normal saline(control);(2) 0.3 mmol/L VitC(Lo VitC); or(3) 3 mmol/L VitC(Hi VitC, final concentrations) and stored appropriately. The Vit C additive was preservative-free buffered ascorbic acid in water, pH 5.5 to 7.0, adjusted with sodium bicarbonate and sodium hydroxide. The doses of Vit C used here correspond to plasma Vit C levels reported in recently completed clinical trials. Prior to supplementation, a baseline sample was collected for analysis. PLTs were sampled again on days 2, 5 and 8 and assayed for changes in PLT function by: Thromboelastography(TEG), for changes in viscoelastic properties; aggregometry, for PLT aggregation and adenosine triphosphate(ATP) secretion in response to collagen or adenosine diphosphate(ADP); and flow cytometry, for changes in expression of CD-31, CD41 a, CD62 p and CD63. In addition, PLT intracellular Vit C content was measured using a fluorimetric assay for ascorbic acid and PLT poor plasma was used for plasma coagulation tests [prothrombin time(PT), partial thrombplastin time(PTT), functional fibrinogen] and Lipidomics analysis(UPLC ESI-MS/MS).RESULTS VitC supplementation significantly increased PLTs intracellular ascorbic acid levels from 1.2 mmol/L at baseline to 3.2 mmol/L(Lo VitC) and 15.7 mmol/L(Hi VitC, P < 0.05). VitC supplementation did not significantly change PT and PTT values, or functional fibrinogen levels over the 8 d exposure period(P > 0.05). PLT function assayed by TEG, aggregometry and flow cytometry was not significantly altered by Lo or Hi VitC for up to 5 d. However, PLTs exposed to 3 mmol/L VitC for 8 d demonstrated significantly increased R and K times by TEG and a decrease in the α-angle(P < 0.05). There was also a fall of 20 mm in maximum amplitude associated with the Hi VitC compared to both baseline and day 8 saline controls. Platelet aggregation studies, showed uniform declines in collagen and ADP-induced platelet aggregations over the 8-d study period in all three groups(P > 0.05). Collagen and ADP-induced ATP secretion was also not different between the three groups(P > 0.05). Finally, VitC at the higher dose(3 mmol/L) also induced the release of several eicosanoids including thromboxane B2 and prostaglandin E2, as well as products of arachidonic acid metabolism via the lipoxygenases pathway such as 11-/12-/15-hydroxyicosatetraenoic acid(P < 0.05).CONCLUSION Alterations in PLT function by exposure to 3 mmol/L VitC for 8 d suggest that caution should be exerted with prolonged use of intravenous high dose VitC.

Assessment of platelet function: Laboratory and point-of-care methods

In the event of blood vessel damage, human platelets are promptly recruited on the site of injury and, after their adhesion, activation and aggregation, prevent blood loss with the formation of a clot. The consequence of abnormal regulation can be either hemorrhage or the development of thrombosis. Qualitative and/or quantitative defects in platelets promote bleeding, whereas the residual reactivity of platelets, despite antiplatelet therapies, play an important role in promoting arterial thrombotic complications. Platelet function is traditionally assessed to investigate the origin of a bleeding syndrome, to predict the risk of bleeding prior surgery or during pregnancy or to monitor the efficacy of antiplatelet therapy in thrombotic syndromes that, now, can be considered a new discipline. "Old" platelet function laboratory tests such as the evaluation of bleeding time and the platelet aggregation analysis inplatelet-rich plasma are traditionally utilized to aid in the diagnosis and management of patients with platelet and hemostatic disorders and used as diagnostic tools both in bleeding and thrombotic diathesis in specialized laboratories. Now, new and renewed automated systems have been introduced to provide a simple, rapid assessment of platelet function including point of care methods. These new methodologies are also suitable for being used in non-specialized laboratories and in critical area for assessing platelet function in whole blood without the requirement of sample processing. Some of these methods are also beginning to be incorporated into routine clinical use and can be utilized as not only as first panel for the diagnosis of platelet dysfunction, but also for monitoring anti-platelet therapy and to potentially assess risk of both bleeding and/or thrombosis.

Platelet function monitoring guided antiplatelet therapy in patients receiving high-risk coronary interventions

Background Large-scale clinical trials have shown that routine monitoring of the platelet function in patients after percutanous coronary intervention （PCI） is not necessary. However, it is still unclear whether patients received high-risk PCI would benefit from a therapy which is guided by a selective platelet function monitoring. This explanatory study sought to assess the benefit of a therapy guided by platelet function monitoring for these patients. Methods Acute coronary syndrome （ACS） patients （n=384） who received high-risk, complex PCI were randomized into two groups. PCI in the two types of lesions described below was defined as high-risk, complex PCI： lesions that could result in severe clinical outcomes if stent thrombosis occurred or lesions at high risk for stent thrombosis. The patients in the conventionally treated group received standard dual antiplatelet therapy. The patients in the platelet function monitoring guided group received an antiplated therapy guided by a modified thromboelastography （TEG） platelet mapping： If inhibition of platelet aggregation （IPA） induced by arachidonic acid （AA） was less than 50% the aspirin dosage was raised to 200 mg/d; if IPA induced by adenosine diphosphate （ADP） was less than 30% the clopidogrel dosage was raised to 150 mg/d, for three months. The primary efficacy endpoint was a composite of myocardial infarction, emergency target vessel revascularization （eTVR）, stent thrombosis, and death in six months. Results This study included 384 patients; 191 and 193 in the conventionally treated group and platelet function monitoring guided group, respectively. No significant differences were observed in the baseline clinical characteristics and interventional data between the two groups. In the platelet function monitoring guided group, the mean IPA induced by AA and ADP were （69.2＋24.5）% （range, 4.8% to 100.0%） and （51.4＋29.8）% （range, 0.2% to 100.0%）, respectively. The AA- induced IPA of forty-three （22.2%） patients was less than 50% and the ADP-induced IPA of fifty-seven （29.5%） patients was less than 30%; therefore, their drug dosages were adjusted. The TEG was rechecked one to four weeks after PCI, and the results indicated that the IPAs had significantly improved （P 〈0.01）. However, no significant differences were found in the rates of the primary efficacy endpoint. Rates in the conventionally treated group and platelet function monitoring guided group were 4.7% and 5.2%, respectively （hazard ratio： 1.13; P=0.79）. Conclusion An antiplatelet therapy guided by TEG monitored platelet function could not improve clinical efficacy even in ACS patients treated with high-risk complex PCI.

THE EFFECT OF LOW DOSE ASPIRIN ON THE PLATELET FUNCTION IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION (AMI)

To assess the optimal dose of aspirin （ASA） in the treatment of AMI, 60 cases of AMI: 1. admitted within 24 hours after onset of illness, 2. ASA not used within one week before, 3. any other drugs influencing the platelet function also not used during the course of study, were randomized into two groups, 30 cases each: one with conventional therapy as control, the other combined with daily oral ASA 100mg. They were matched in sex, age, infarct site and coexistent conditions （hypertension, diabetes mellitus, hyperlipemia, smoking etc.）. The second group was further divided into subgroup I with serum peak CK<1000 U/L and subgroup Ⅱ with serum peak CK>1000 U/L. The parameters of platelet function including plasma TXB/6-keto-PGF, platelet aggregation induced by 5-HT and epinephrine were studied on different days for 3 weeks. Twenty healthy persons were selected for normal value of platelet function.

The impact of different doses of atorvastatin on plasma endothelin and platelet function in acute ST-segment elevation myocardial infarction after emergency percutaneous coronary intervention

Objective To investigate the effects of different doses of atorvastatin on plasma endothelin and platelet function in acute ST-segment elevation myocardial infarction(STEMI)patients after emergency percutaneous coronary intervention(PCI).Methods A total of 120 patients with acute STEMI treated with emergency PCI were enrolled and randomly divided into 20 mg of atorvastatin treatment group(standard group,n=60),and 40 mg of atorvastatin treatment group(intensive group,n=60).

The Relationship Between P-Selectin on Platelet Membrane and Platelet Function in Chronic Cor Pulmonale.

Platelet plays an importent role in thromboembolic diseases. It is demonstrated that recurrent pulmonary embolism may cause pulmonary hypertention. In recent years，P-selectin（granule membrane protein，GMP40）was found to be a surface marker for platelet activation.

Preparation of Functionalized Graphene Nano-platelets and Use for Adsorption of Pb2+ from Solution

Functionalized graphene nano-platelets(FGN) were obtained via treating graphene nanoplatelets(GN) with HNO3, and served as adsorbent for the removal of Pb2+from solutions. We investigated the FGN adsorption capacity for Pb2+at different initial concentrations, varying pH, contact time and temperature. The characterization results of scanning electron microscopy(SEM), thermal analysis(TG/DTG), Fourier transform infrared spectroscopy(FT-IR) and Brunauer-Emmett-Teller(BET) method indicated that FGN layers were thin and possess large specific area with oxygen-containing functional groups grafted onto their surface. Meanwhile, the determined equilibrium adsorption capacity of FGN for Pb2+was 57.765 mg/g and adsorption isotherms well confirmed to Langmuir isotherms models. The results reveals that the FGN has better effect of water treatment.

Association of α_(2A)-Adrenergic Receptor Genetic Variants with Platelet Reactivity in Chinese Patients on Dual Antiplatelet Therapy Undergoing Percutaneous Coronary Intervention

Objective The alpha 2A-adrenergic receptor gene （ADRA2A） polymorphism in individuals antiplatelet response to sympathetic stimulation. The aim of this study was to investigate ADRA2A variants on platelet reactivity in Chinese patients on dual antiplatelet therapy undergoing percutaneous coronary intervention （PCI）. modifies the the effect of （DAPT） after Methods From March 2011 to March 2013, 1,024 patients were enrolled in this prospective, single-center, observational study in China. Four single nucleotide polymorphisms （SNPs） of ADRA2A gene （rs11195419, rs3750625, rs13306146, and rs553668） and CYP2C19^＊2 were detected by ligase detection reaction （LDR）, and adenosine diphosphate （ADP） inhibition was detected by thromboelastography （TEG）. Results The minor allele frequencies of ADRA2A SNPs were common. Platelet ADP inhibition was significantly different among patients carrying rs11195419 （adjusted P = 0.022） and rs3750625 （adjusted P = 0.016）. The homozygous allele carriers had the lowest ADP inhibition. However, ADP inhibition was not significantly different in rs553668 and rs13306146. At the multivariate analysis, rs11195419 （P = 0.033）, rs3750625 （P = 0.020） and CYP2C19＂2 （P = 0.002） were independent predictors of ADP inhibition. Subgroups analysis based on sex showed rs11195419 （P = 0.003） and rs3750625 （P = 0.002） were significantly associated with ADP inhibition in males, but not in females. Conclusion ADRA2A genetic variations were associated with ADP-induced platelet aggregation during DAPT in Chinese patients undergoing PCI, and the effect was particularly more pronounced in males.

New parameter in diagnosis of acute appendicitis:Platelet distribution width

AIM:To investigate the diagnostic accuracy of the mean platelet volume and platelet distribution width in acute appendicitis.METHODS:This retrospective,case-controlled study compared 295 patients with acute appendicitis(Group?Ⅰ),100 patients with other intra-abdominal infections(GroupⅡ),and 100 healthy individuals(GroupⅢ)between January 2012 and January 2013.The age,gender,and white blood cell count,neutrophil percentage,mean platelet volume,and platelet distribution width values from blood samples were compared among the groups.Statistical analyses were performed using SPSS for Windows 21.0 software.In addition,the sensitivity,specificity,positive and negative predictive values and likelihood ratios,and diagnostic accuracy were calculated.RESULTS:The mean ages of patients were 29.9±12.0years for Group?Ⅰ,31.5±14.0 years for GroupⅡ,and30.4±13.0 years for GroupⅢ.Demographic features such as age and gender were not significantly different among the groups.White blood cell count,neutrophil percentage and platelet distribution width were significantly higher in Group?Ⅰ?compared to groupsⅡandⅢ(P<0.05).Diagnostically,the sensitivity,specificity and diagnostic accuracy were 73.1%,94.0%,and 78%for white blood cell count,70.0%,96.0%,and 76.0%for neutrophil percentage,29.5%,49.0%,and 34.0%for mean platelet volume,and 97.1%,93.0%,and 96.0%for platelet distribution width,respectively.The highest diagnostic accuracy detected was for platelet distribution width between Group?Ⅰ?and GroupⅢ(P<0.01).CONCLUSION:Platelet distribution width analysis can be used for diagnosis of acute appendicitis without requiring additional tests,thus reducing the cost and loss of time.

Ratio of mean platelet volume to platelet count is a potential surrogate marker predicting liver cirrhosis

AIM To provide a simple surrogate marker predictive of liver cirrhosis(LC).METHODS Specimens from 302 patients who underwent resection for hepatocellular carcinoma between January 2006 and December 2012 were retrospectively analyzed. Based on pathologic findings, patients were divided into groups based on whether or not they had LC. Parameters associated with hepatic functional reserve were compared in these two groups using MannWhitney U-test for univariate analysis. Factors differing significantly in univariate analyses were entered into multivariate logistic regression analysis.RESULTS There were significant differences between the LC group(n = 100) and non-LC group(n = 202) in prothrombin activity, concentrations of alanine aminotransferase, aspartate aminotransferase, total bilirubin, albumin, cholinesterase, type Ⅳ collagen, hyaluronic acid, indocyanine green retention rate at 15 min, maximal removal rate of technitium-99 m diethylene triamine pentaacetic acid-galactosyl human serum albumin and ratio of mean platelet volume to platelet count(MPV/PLT). Multivariate analysis showed that prothrombin activity, concentrations of alanine aminotransferase, aspartate aminotransferase, total bilirubin and hyaluronic acid, and MPV/PLT ratio were factors independently predictive of LC. The area under the curve value for MPV/PLT was 0.78,with a 0.8 cutoff value having a sensitivity of 65% and a specificity of 78%.CONCLUSION The MPV/PLT ratio, which can be determined simply from the complete blood count, may be a simple surrogate marker predicting LC.

Subtenon Injection of Autologous Platelet-Rich Plasma in Retinitis Pigmentosa: Is It a New Therapeutic Option?

Purpose: Growth factors (GFs) and neurotrophins can decelerate retinal degeneration. This study aimed to investigate the safety, efficacy and durability of subtenon injections of autologous platelet-rich plasma (aPRP) which is a rich source of GFs in retinitis pigmentosa (RP) patients. Methods: 154 eyes of 77 RP patients with various degrees of narrowed visual field were investigated in this study. Each patient received three injections with 4-week intervals and followed for at least 12 months. The examinations and the tests were obtained before the injection, 1 month after the third injection and every 3 months during the study. The primary aim was to evaluate the effects of aPRP on visual acuity (VA) and visual functions, the second aim was to estimate the duration of the therapy effect and the need for additional aPRP injection. Results: Median age of the 77 RP patients was 35.2 ± 13.9 years. All of the eyes received 3 monthly bilateral subtenon aPRP injections. Of these patients 26 received an additional one, 12 received additional two and 1 patient received additional 3 injections with 3-month interval. There were no significant ocular or systemic side effects. The mean baseline VA was 0.22 ± 0.18 Snellen lines. It improved to 0.31 ± 0.19 following three aPRP injections, which was statistically significant. At the end of the study period, the mean VA was 0.27 ± 0.22 Snellen lines. Conclusion: The subtenon injection of aPRP might be an effective therapy and might have a positive influence in the preservation of visual functions and visual acuity of RP patients.

Platelet aggregation is affected by nitrosothiols in patients with chronic hepatitis: In vivo and in vitro studies

AIM: To investigate the relationship among the number of platelets and plasma levels of S-nitrosothiols (S-NO), nitrite, total non-protein SH (NPSH), glutathione (GSH), cysteine (CYS), malondialdehyde (MDA), 4-hydroxininenal (4HNE), tumor necrosis factor-alpha (TNFα) and interleukin (IL)-6 in patients with chronic hepatitis C (CH).METHODS: In vitro the aggregation of platelets derived from controls and CH patients was evaluated before and after the addition of adenosine diphosphate (ADP) and collagen, both in basal conditions and after incubation with nitrosoglutathione (GSNO). RESULTS: In vivo , S-NO plasma levels increased significantly in CH patients and they were significantly directly correlated with platelet numbers. Patients with platelet counts < 150 000/μL, had a smaller increase in S-NO, lower levels of GSH, CYS, NPSH, TNFα, and IL-6, and higher levels of nitrite, MDA, and 4-HNE relative to those of patients with platelet counts > 150 000/μL. In vitro, the ADP and collagen aggregation time was increased in platelets from patients and not from controls; in addition, platelets from CH patients but not from controls also showed a latency time after exposure to collagen. CONCLUSION: The incubation of platelets with GSNO improved the percentage aggregation and abolished the latency time.

足月妊娠孕妇血栓弹力图和Sonoclot凝血和血小板功能参考值范围及相关性的探讨

目的建立健康足月妊娠孕妇血栓弹力图和Sonoclot凝血和血小板功能检测参考值范围。方法选取入住我院产科无凝血系统疾病等情况的足月妊娠孕妇160例,通过血栓弹力图(TEG)和Sonoclot检测,统计分析R值、K值、Angle值、MA值以及ACT、CR、PF,建立其参考值范围。结果160例足月妊娠孕妇的TEG和Sonoclot检测,至少一项超过厂商推荐参考值范围为异常,异常率TEG为71.70%,Sonoclot为56.87%。本研究中TEG指标的参考值范围:R3.4~7.9min,K0.9~3.0min,Angle 62.9~72.9°,MA 48.0~83.6mm;ACT 125.5~184.5s、CR 20.2~63.6clot/min、PF 0.6~4.7。在两种检测方法之间,所有检验指标间仅ACT与R值有相关性(P<0.05)。结论妊娠期孕妇的凝血状态与非孕正常人群有着明显的差别,其厂商提供在TEG和Sonoclot凝血与血小板功能分析的参考值范围不适用于足月妊娠孕妇,需要重新建立这两个项目的参考值范围以便临床诊疗的准确进行。

4℃保存全血制备的去白细胞混合浓缩血小板体外质量评价

目的 探讨全血4℃冷藏条件下保存制备去白细胞混合浓缩血小板的可行性,为成分制备提供理论依据。方法 将采集的400 mL ACD-B抗凝全血随机分两组,分别进行4℃和室温保存,在保存后6 h内分离制备出白膜层,于22℃静置过夜保存,次日将白膜层汇集制备去白细胞混合浓缩血小板,于制备后d1、d3、d5、d7取样,进行血细胞计数及相关参数检测,测定pH、葡萄糖、乳酸含量反映代谢情况,检测血栓弹力图、血小板聚集率及PAC-1、CD62P反映血小板体外功能及活化情况,比较两组血小板差异。结果 随着保存时间的延长,两组去白细胞混合浓缩血小板计数逐渐下降,血小板分布宽度(PDW)、平均血小板体积(MPV)、大型血小板比例(P-LCR)均逐渐上升,差异无统计学意义(P>0.05)。两组去白细胞混合浓缩血小板pH、葡萄糖含量均逐渐降低,乳酸含量逐渐增高,无显著性差异(P>0.05)。血栓弹力图结果显示,反应血小板功能的MA值保存期内无显著性变化,且两组间无显著性差异(P>0.05)。血小板聚集率随着保存时间的延长而逐渐降低,两组无统计学差异。血小板PAC-1及CD62P表达率随着保存时间的延长而逐渐升高,两组无统计学差异(P>0.05)。结论 全血4℃冷藏保存与室温保存6 h内制备的去白细胞混合浓缩血小板在体外计数、功能、活化方面无统计学差异,4℃冷藏6 h内的全血可考虑作为制备去白细胞混合浓缩血小板的起始血液。

艾灸联合曲美他嗪对老年冠心病稳定型心绞痛患者血小板聚集功能的影响

目的 探讨艾灸联合曲美他嗪用于老年冠心病稳定型心绞痛的效果,观察血小板聚集功能变化。方法 选取2020年1月至2022年1月收治的冠心病稳定型心绞痛患者96例,随机数字表法分为观察组和对照组,每组48例。对照组给予曲美他嗪治疗,观察组在对照组基础上加用艾灸治疗。观察2组患者临床疗效,比较2组患者治疗前后中医证候评分、心功能[左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)]、血小板聚集功能、心绞痛发作次数、持续时间及西雅图心绞痛量表(SAQ)评分,观察不良反应发生情况。结果 观察组临床总有效率显著高于对照组(P<0.05);观察组胸痛胸闷、面色暗紫、痰多体胖、倦态乏力评分均低于治疗前且低于对照组治疗后(P<0.05);治疗后观察组2.5μmol/L、5μmol/L、300μmol/L诱导剂下的血小板聚集均显著低于治疗前且低于对照组治疗后(P<0.05);观察组LVEF、SAQ量表高于治疗前及对照组,LVEDD、LVESD、心绞痛发作次数、持续时间低于治疗前及对照组(P<0.05);2组患者不良反应差异无统计学意义(P>0.05)。结论 艾灸联合曲美他嗪可改善老年冠心病稳定型心绞痛患者心功能、血小板聚集功能,减少患者心绞痛频率及持续时间,安全性高。

Comparative studies between humans and golden Syrian hamsters via thromboelastography

Background:Thromboelastography(TEG)is a widely utilized clinical testing method for real-time monitoring of platelet function and the thrombosis process.Lipid metab-olism disorders are crucial risk factors for thrombosis.The lipid metabolism charac-teristics of hamsters resemble those of humans more closely than mice and rats,and their relatively large blood volume makes them suitable for studying the mechanisms of thrombosis related to plasma lipid mechanisms.Whole blood samples from golden Syrian hamsters and healthy humans were obtained following standard clinical pro-cedures.TEG was employed to evaluate coagulation factor function,fibrinogen(Fib)function,platelet function,and the fibrinolytic system.Methods:The whole blood from hamster or healthy human was isolated following the clinical procedure,and TEG was employed to evaluate the coagulation factor func-tion,Fib function,platelet function,and fibrinolytic system.Coagulation analysis used ACLTOP750 automatic coagulation analysis pipeline.Blood routine testing used XN-2000 automatic blood analyzer.Results:TEG parameters revealed that hamsters exhibited stronger coagulation fac-tor function than humans(reaction time[R],p=0.0117),with stronger Fib function(alpha angle,p<0.0001;K-time[K],p<0.0001).Platelet function did not differ signifi-cantly(maximum amplitude[MA],p=0.077).Hamsters displayed higher coagulation status than humans(coagulation index[CI],p=0.0023),and the rate of blood clot dissolution in hamsters differed from that in humans(percentage lysis 30 min after MA,p=0.02).Coagulation analysis parameters indicated that prothrombin time(PT)and activated partial thromboplastin time(APTT)were faster in hamsters than in hu-mans(PT,p=0.0014;APTT,p=0.03),whereas the Fib content was significantly lower in hamsters than in humans(p<0.0001).No significant difference was observed in thrombin time(p=0.1949).Conclusions:In summary,TEG could be used to evaluate thrombosis and bleeding parameters in whole blood samples from hamsters.The platelet function of hamsters closely resembled that of humans,whereas their coagulation function was signifi-cantly stronger.

凝血功能和血小板各项参数对重症肝硬化患者的检测价值

目的探究凝血功能和血小板各项参数对重症肝硬化患者的检测价值。方法选择柳州市柳铁中心医院自2019年1月—2020年12月广西柳州市柳铁中心医院收治的80例重症肝硬化患者作为研究对象(设为研究组),另同期80例非肝硬化患者作为参照对象(设为对照组),两组研究对象均行凝血功能和血小板检测,对比两组研究对象凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)等凝血功能水平、血小板计数(PLT)、血小板压积(PCT)、平均血小板体积(MPV)、血小板分布宽度(PDW)等血小板参数水平、单用凝血功能、血小板各项参数及凝血功能联合血小板各项参数对重症肝硬化检测诊断的准确率。结果研究组患者TT、PT、APTT、MPV、PDW水平均显著高于对照组,研究组患者FIB、PLT、PCT水平均显著低于对照组,两组对比差异具有统计学意义(P<0.05),且凝血功能联合血小板各项参数对重症肝硬化检测诊断的准确率显著高于单用凝血功能、血小板各项参数检测,组间对比差异具有统计学意义(P<0.05)。结论凝血功能和血小板各项参数对重症肝硬化患者的检测价值显著,有利于患者病情的评估。

凝血功能联合平均血小板体积与血小板计数比值对脑梗死的诊断价值

目的探讨凝血功能指标联合平均血小板体积与血小板计数比值对急性脑梗死(ACI)的诊断价值。方法95例ACI患者按照疾病严重程度分为轻度39例、中度37例及重度19例,比较不同程度ACI患者入院时的凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、凝血酶时间(TT)、D二聚体(D-Dimer)、纤维蛋白溶解产物(FDP)]和平均血小板体积与血小板计数比值;采用ROC曲线下面积(AUC)评估凝血功能指标、平均血小板体积与血小板计数比值单项或联合检测对ACI严重程度的诊断价值;采用Pearson相关系数(r)分析各项检测指标与ACI的相关性。结果轻度组患者PT、APTT及TT长于中度组和重度组,FIB、D-Dimer、FDP及平均血小板体积与血小板计数比值低于中度组和重度组,差异有统计学意义(P<0.05);ROC曲线结果显示,凝血功能指标、平均血小板体积与血小板计数比值联合检测诊断ACI的AUC为0.943,高于其他单项检测的AUC;相关性分析显示,ACI患者PT、APTT、FIB、TT、D-Dimer、FDP及平均血小板体积与血小板计数比值均存在一定的相关性(P<0.05)。结论不同严重程度ACI患者的凝血功能指标及平均血小板体积与血小板计数比值存在明显差异,凝血功能指标及平均血小板体积与血小板计数比值对ACI诊断具有一定价值,联合检测诊断价值更高。