Vecht C J, Minderhoud J M, Sibinga C T
J Clin Pathol. 1975 Oct;28(10):814-20. doi: 10.1136/jcp.28.10.814.
ADP-induced platelet aggregation was studied for up to six weeks in 34 patients with head injuries. The patients were divided into three groups according to the degree of impaired consciousness assessed by a clinical coma scale, and change in platelet aggregation was related to the coma score. Platelet aggregation was markedly reduced in all eight patients dying within 24 hours of injury. All 17 patients who remained unconscious for four days or more showed decreased platelet aggregation up to nine days after admission, the most marked effect being on the second day. Platelet function in this group returned to normal within 16 days. Nine patients with only slightly impaired consciousness also showed subnormal platelet aggregation during the first few days with a return to normal by the fourth day. Platelet counts remained within normal limits in all groups. We suggest that during coma following head injury brainstem dysfunction induces neurohumoral changes in the blood which are responsible for a decrease in platelet function.
对34例头部受伤患者进行了长达六周的ADP诱导的血小板聚集研究。根据临床昏迷量表评估的意识受损程度将患者分为三组，血小板聚集的变化与昏迷评分相关。在受伤后24小时内死亡的所有8例患者中，血小板聚集明显降低。所有17例昏迷持续四天或更长时间的患者在入院后九天内血小板聚集均降低，最明显的影响在第二天。该组患者的血小板功能在16天内恢复正常。9例意识仅轻微受损的患者在最初几天也表现出血小板聚集低于正常水平，并在第四天恢复正常。所有组的血小板计数均保持在正常范围内。我们认为，头部受伤后的昏迷期间，脑干功能障碍会引起血液中的神经体液变化，这是导致血小板功能下降的原因。
