Wuillemin Walter A, Gasser K atherina M, Zeerleder Sacha S, Lämmle Bernhard
Division of Haematology, Kantonsspital Luzern, Switzerland.
Swiss Med Wkly. 2002 Aug 10;132(31-32):443-8. doi: 10.4414/smw.2002.10039.
To investigate pre-analytical variables and the diagnostic performance of the platelet function analyser (PFA-100), a new device to test primary haemostasis in vitro by simulating platelet adhesion and aggregation under high shear stress.
Venous whole citrated blood is aspirated through a capillary towards an aperture of a collagen coated membrane containing either adenosine diphosphate (ADP) or epinephrine (EPI). The time needed for occluding this aperture by plug formation is called closure time (CT) and was assessed in 70 healthy subjects and 43 patients with a suspected mild bleeding disorder.
The reference range for the PFA-100 was found to be 82-159 s for EPI-CT and 62.5-120.5 s for ADP-CT. Duplicate analyses revealed a mean coefficient of variations of 7.1% (EPI-CT) and 5.7% (ADP-CT). The EPI- and ADP-CT of blood samples collected in the evening were significantly longer (p = 0.002 and p = 0.004, respectively) than the CT of blood samples collected in the morning. Acetylsalicylic acid(100 mg, 300 mg or 500 mg) administered as a single dose or daily on 10 consecutive days resulted in a prolongation of the EPI-CT, whereas the ADP-CT was not affected. EPI-CT was more sensitive in detecting acetylsalicylic acid (ASA) ingestion than was the bleeding time (BT). Sensitivity and specificity of the PFA-100 to detect von Willebrand disease (vWD) were comparable to the results obtained with the BT.
The PFA-100 represents a simple and easy to use test for investigation of primary haemostasis. Limitations of the system are: special citrated whole blood has to be proceeded within 0.5 to 4 h after sampling, duplicate measurements are necessary, and the results differ between blood sampled in the morning or in the afternoon. The data indicate that the test is sensitive to ASA intake and vWD. Its use is preferable to BT determination, because it is less invasive and more sensitive to abnormalities of primary haemostasis.
研究分析前变量以及血小板功能分析仪（PFA - 100）的诊断性能，该仪器是一种通过在高剪切应力下模拟血小板黏附和聚集来体外检测初级止血功能的新设备。
通过毛细管将静脉枸橼酸化全血抽吸至含有二磷酸腺苷（ADP）或肾上腺素（EPI）的胶原包被膜的小孔处。通过形成凝块阻塞该小孔所需的时间称为封闭时间（CT），并在70名健康受试者和43名疑似轻度出血性疾病的患者中进行评估。
发现PFA - 100的参考范围为：EPI - CT为82 - 159秒，ADP - CT为62.5 - 120.5秒。重复分析显示平均变异系数为：EPI - CT为7.1%，ADP - CT为5.7%。晚上采集的血样的EPI - CT和ADP - CT显著长于（分别为p = 0.002和p = 0.004）早上采集的血样的CT。单剂量或连续10天每日给予乙酰水杨酸（100毫克、300毫克或500毫克）会导致EPI - CT延长，而ADP - CT不受影响。EPI - CT在检测乙酰水杨酸（ASA）摄入方面比出血时间（BT）更敏感。PFA - 100检测血管性血友病（vWD）的敏感性和特异性与BT获得的结果相当。
PFA - 100是一种用于研究初级止血功能的简单易用的检测方法。该系统的局限性在于：特殊的枸橼酸化全血必须在采样后0.5至4小时内进行处理，需要重复测量且上午或下午采集的血样结果不同。数据表明该检测对ASA摄入和vWD敏感。其应用优于BT测定，因为它侵入性较小且对初级止血异常更敏感。
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