Smith N A, Watts M, Simpson A W, Boughton B J
Department of Haematology, Queen Elizabeth Hospital, Edgbaston, Birmingham, UK.
Infusionsther Transfusionsmed. 1992 Aug;19(4):197-8. doi: 10.1159/000222622.
15 patients underwent plasma exchange using a standard 170-microns in-line filter with or without an additional 40-microns microaggregate filter in the return circuit. The mean platelet count fall immediately after plasma exchange in 15 patients was (54 +/- 6) x 10(9)/l and 48 h later was (23 +/- 8) x 10(9)/l representing a mean total platelet loss immediately after plasma exchange of (253 +/- 31) x 10(9) with no difference in the 40-microns filtered procedures. The mean platelet loss in the discarded plasma was (60 +/- 8) x 10(9), and a mean of 52 x 10(9) platelets were recovered from machine harness washings. The platelet loss in the removed plasma and in the harness therefore accounted for only 42-44% of the total loss of platelets. The inclusion of 40-microns microaggregate filters did not reduce platelet loss, and it is therefore unlikely that the thrombocytopenia is induced by reinfused microaggregates. It is likely that platelets are activated in the machine and sequestered in the spleen.
15名患者接受了血浆置换，使用标准的170微米在线滤器，回流回路中使用或不使用额外的40微米微聚体滤器。15名患者血浆置换后立即的平均血小板计数下降为(54±6)×10⁹/L，48小时后为(23±8)×10⁹/L，这意味着血浆置换后立即的平均总血小板损失为(253±31)×10⁹，40微米过滤程序之间无差异。废弃血浆中的平均血小板损失为(60±8)×10⁹，从机器管道冲洗液中平均回收52×10⁹个血小板。因此，去除的血浆和管道中的血小板损失仅占血小板总损失的42%-44%。使用40微米微聚体滤器并未减少血小板损失，因此血小板减少不太可能是由回输的微聚体引起的。血小板很可能在机器中被激活并在脾脏中被隔离。
