Stohlawetz P, Kapiotis S, Seidl D, Hergovich N, Zellner M, Eichler H G, Stiegler G, Leitner G, Höcker P, Jilma B
Department of Clinical Pharmacology, TARGET, Vienna University Hospital School of Medicine, Austria.
Transfusion. 1999 Apr;39(4):420-7. doi: 10.1046/j.1537-2995.1999.39499235677.x.
Although many donors undergo repeated plateletpheresis, data on the consequences of plateletpheresis for the donor's health remain scarce. Thus, the effect of plateletpheresis on the activation of coagulation, fibrinolysis, and neutrophils was investigated.
Part 1: Sixteen healthy men were randomly assigned to undergo plateletpheresis on a cell separator (AMICUS, Fenwal Baxter; or MCS 3p, Haemonetics). The effects of plateletpheresis on plasma levels of prothrombin fragment (F(1+2)), D-dimer, plasmin-plasmin inhibitor (PPI) complexes, and plasminogen activator inhibitor (PAI-1); on the activation of neutrophils (% L-selectin+); and on the frequency of platelet-neutrophil aggregates (% CD41+ neutrophils) were compared. Part 2: Ten healthy men received infusions of ACD-A and placebo without apheresis in a randomized, double-blind crossover study to control for the pharmacologic effects of citrate.
Part 1: No change in F(1+2) occurred (p>0.05), which indicated that plateletpheresis did not enhance coagulation. Levels of D-dimer, PPI, and PAI-1 decreased over time on the AMICUS (p<0.001). Plateletpheresis did not activate neutrophils (p>0.05), but it decreased the percentage of CD41+ neutrophils (p<0.003). An approximately 80-percent drop in mononuclear cells was observed in the extracorporeal circulation of the AMICUS (p<0.001 vs. baseline and p = 0.005 vs. MCS 3p), and circulating lymphocyte and monocyte counts decreased concomitantly. Part 2: Infusion of ACD-A slightly decreased D-dimer levels (p<0.05), and both infusions decreased the circulating lymphocyte counts.
Plateletpheresis can be regarded as safe with respect to the activation of coagulation or neutrophils. The consequences for the donor's health of the decrease in D-dimer, PPI, and PAI-1 may deserve further investigation.
尽管许多献血者接受多次血小板单采术，但关于血小板单采术对献血者健康影响的数据仍然很少。因此，研究了血小板单采术对凝血、纤维蛋白溶解和中性粒细胞激活的影响。
第1部分：16名健康男性被随机分配在血细胞分离机（AMICUS，芬瓦尔德百特公司；或MCS 3p，海莫奈提克斯公司）上进行血小板单采术。比较了血小板单采术对血浆凝血酶原片段（F(1+2)）、D-二聚体、纤溶酶-纤溶酶抑制剂（PPI）复合物和纤溶酶原激活物抑制剂（PAI-1）水平的影响；对中性粒细胞激活（% L-选择素阳性）的影响；以及对血小板-中性粒细胞聚集体频率（% CD41阳性中性粒细胞）的影响。第2部分：在一项随机、双盲交叉研究中，10名健康男性接受了ACD-A和安慰剂输注，未进行单采术，以控制柠檬酸盐的药理作用。
第1部分：F(1+2)未发生变化（p>0.05），这表明血小板单采术未增强凝血。在AMICUS上，D-二聚体、PPI和PAI-1水平随时间下降（p<0.001）。血小板单采术未激活中性粒细胞（p>0.05），但降低了CD41阳性中性粒细胞的百分比（p<0.003）。在AMICUS的体外循环中观察到单核细胞下降约80%（与基线相比p<0.001，与MCS 3p相比p = 0.005），循环淋巴细胞和单核细胞计数随之下降。第2部分：输注ACD-A使D-二聚体水平略有下降（p<0.05），两种输注均使循环淋巴细胞计数下降。
就凝血或中性粒细胞激活而言，血小板单采术可被视为安全的。D-二聚体、PPI和PAI-1下降对献血者健康的影响可能值得进一步研究。
