Bowbrick Virginia A, Mikhailidis Dimitri P, Stansby Gerard
Academic Surgical Unit, Imperial College School of Medicine, St. Mary's Hospital, London, UK.
Platelets. 2003 Jun;14(4):219-24. doi: 10.1080/0953710031000118849.
It has been suggested that thromboelastography TEG) can help in limiting or directing the appropriate use of blood products during surgery. However, the contribution of platelets to the TEG profile has not been studied in detail. Blood was taken from eight healthy subjects and eight patients with peripheral arterial disease (PAD). Immunomagnetic separation was achieved by the addition of Dynabeads labeled with a CD41 murine antibody (to the GPIIb/IIIa receptor) to achieve 90-100% depletion of platelets from blood. This was then titrated with whole blood to achieve platelet counts of approximately 0, 25 and 50% of the original count to compare with whole blood using TEG. Platelet function was also assessed by spontaneous platelet aggregometry (SPA) at baseline and at the 50% dilution. SPA, maximum amplitude (MA) and K time were significantly different in PAD patients compared to controls (P < 0.05). In both controls and PAD patients there was a strong linear correlation between Log10 [platelet count] and MA (r = 0.97 for controls, r = 0.89 for PAD) and K time (r = -0.86 for controls, r = -0.68 for PAD). Correlation between Log10 [platelet count] and R time was poor in both groups. The MA and K TEG parameters may be most useful for assessing platelet transfusion requirements.
有人提出，血栓弹力图（TEG）有助于在手术期间限制或指导血液制品的合理使用。然而，血小板对TEG结果的影响尚未得到详细研究。采集了8名健康受试者和8名外周动脉疾病（PAD）患者的血液。通过添加标记有CD41鼠抗体（针对糖蛋白IIb/IIIa受体）的磁珠实现免疫磁珠分离，以使血液中的血小板减少90 - 100%。然后用全血进行滴定，使血小板计数达到原始计数的约0%、25%和50%，以便使用TEG与全血进行比较。还在基线和50%稀释度时通过自发血小板聚集测定法（SPA）评估血小板功能。与对照组相比，PAD患者的SPA、最大振幅（MA）和K时间有显著差异（P < 0.05）。在对照组和PAD患者中，Log10[血小板计数]与MA（对照组r = 0.97，PAD患者r = 0.89）以及K时间（对照组r = -0.86，PAD患者r = -0.68）之间均存在强线性相关性。两组中Log10[血小板计数]与R时间之间的相关性均较差。MA和K TEG参数可能对评估血小板输血需求最有用。
