Igawa T, Kornhauser R, Cilla D D, King J O, Kambayashi J
Otsuka America Pharmaceutical, Inc., Rockville, Maryland 20850, USA.
Clin Appl Thromb Hemost. 1999 Apr;5(2):117-21. doi: 10.1177/107602969900500208.
Several variables affect bleeding time that make it difficult to obtain consistent measurements. The Clot Signature Analyzer (CSA) has been developed to assess in vitro hemostasis using well-controlled flow chambers. In this study, the equivalencies in the CSA parameters with the conventional bleeding time or platelet aggregation methods were evaluated in subjects exposed to aspirin. The CSA parameters, platelet hemostasis time (PHT) and collagen-induced thrombus formation (CITF), were compared to bleeding time (Surgicutt2) and collagen-induced platelet aggregation, respectively. Fifty-three healthy volunteers were given two doses of aspirin (81 and 243 mg) in one day. Following the baseline period, the volunteers took 81 mg of aspirin and then took 243 mg 2 hours later. The changes in each value from the baseline to that at either aspirin dose (2 hours after dosing) were evaluated. Platelet hemostasis time and CITF correlated well with bleeding time and aggregation, respectively, but PHT was not significantly increased after 81 mg of aspirin, whereas bleeding time was significantly increased. The variation in PHT was slightly higher than that of bleeding time. At 81 mg, CITF was significantly increased but aggregation was not, even though the variation was comparable. This suggests that PHT and CITF can simulate the changes in bleeding time and aggregation, respectively, but the sensitivity of PHT for detecting the changes in bleeding time was no better than the conventional method. Also, CITF was more sensitive than aggregation in detecting platelet response to collagen. In conclusion, the proposed CSA is not always suitable for detecting hemostatic abnormalities.
有几个变量会影响出血时间，这使得难以获得一致的测量结果。已经开发出凝块特征分析仪（CSA），以使用控制良好的流动腔室来评估体外止血情况。在本研究中，在服用阿司匹林的受试者中评估了CSA参数与传统出血时间或血小板聚集方法的等效性。分别将CSA参数，即血小板止血时间（PHT）和胶原诱导的血栓形成（CITF），与出血时间（Surgicutt2）和胶原诱导的血小板聚集进行比较。53名健康志愿者在一天内服用了两剂阿司匹林（81毫克和243毫克）。在基线期之后，志愿者服用81毫克阿司匹林，然后在2小时后服用243毫克。评估了从基线到任一阿司匹林剂量（给药后2小时）时每个值的变化。血小板止血时间和CITF分别与出血时间和聚集良好相关，但服用81毫克阿司匹林后PHT没有显著增加，而出血时间显著增加。PHT的变化略高于出血时间的变化。在81毫克时，CITF显著增加，但聚集没有增加，尽管变化相当。这表明PHT和CITF可以分别模拟出血时间和聚集的变化，但PHT检测出血时间变化的敏感性并不比传统方法更好。此外，CITF在检测血小板对胶原的反应方面比聚集更敏感。总之，所提出的CSA并不总是适合检测止血异常。
