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全血捐献者的血小板功能受损:止痛药的影响。

Platelet function in whole-blood donors is impaired: the effects of painkillers.

作者信息

Curvers Joyce, Dielis Arne W J H, Heeremans Judith, van Wersch Jan W J

机构信息

Sanquin Blood Bank Region Southeast, Maastricht, the Netherlands.

出版信息

Transfusion. 2007 Jan;47(1):67-73. doi: 10.1111/j.1537-2995.2007.01065.x.

Abstract

BACKGROUND

Aspirin (ASA) or non-aspirin-like nonsteroidal anti-inflammatory drugs (NSAIDs) influence platelet (PLT) function by inhibiting cyclooxygenase enzymes. In this study, the aim was to address the use of ASA or NSAIDs before donation and the effect on PLT function.

STUDY DESIGN AND METHODS

Donors were asked questions about recent use of ASA or NSAIDs. Furthermore, PLT function was evaluated by measurement of the closure time (CT) in a PLT function analyzer (PFA-100, Dade Behring) and by aggregometry (response to ADP or arachidonic acid [AA]).

RESULTS

Of 100 questioned donors, 22 percent had used ASA (n = 4), NSAIDs (n = 6), or paracetamol (n = 12) before donation. Upon assessment of the PLT function in the PFA-100, 27 donors showed values of greater than 180 seconds, indicative of impaired PLT function. Of these, only 7 had used pain killers before donation. Furthermore, 15 of 22 users had normal CTs. Aggregation after stimulation with AA was absent in 33 PLT-rich samples. Again only 8 had reported use of ASA (3), NSAIDs (1), or paracetamol (4). Of the 22 users, 14 had normal AA aggregation responses. All donor samples showed ADP-induced aggregation, indicating PLT integrity. There was no difference between the group of donors who reported the intake of ASA or NSAIDs and the group of donors who did not with respect to the tested PLT function assays.

CONCLUSION

It is concluded that there is a considerable group of donors that use PLT-influencing medication before donation. A relation between the reported use and impaired PLT function in blood donors could not be established, however. Impaired PLT function as tested may have other causes than intake of ASA or NSAIDs.

摘要

背景

阿司匹林(ASA)或非阿司匹林类非甾体抗炎药(NSAIDs)通过抑制环氧化酶来影响血小板(PLT)功能。在本研究中,目的是探讨献血前使用ASA或NSAIDs的情况及其对PLT功能的影响。

研究设计与方法

询问献血者关于近期使用ASA或NSAIDs的问题。此外,通过血小板功能分析仪(PFA-100,达德拜林公司)测量封闭时间(CT)以及采用凝集测定法(对二磷酸腺苷或花生四烯酸[AA]的反应)来评估PLT功能。

结果

在100名接受询问的献血者中,22%在献血前使用过ASA(n = 4)、NSAIDs(n = 6)或对乙酰氨基酚(n = 12)。在评估PFA-100中的PLT功能时,27名献血者的结果显示大于180秒,表明PLT功能受损。其中,只有7人在献血前使用过止痛药物。此外,22名使用者中有15人的CT值正常。在33个富含血小板的样本中,用AA刺激后无凝集现象。同样,只有8人报告使用过ASA(3人)、NSAIDs(1人)或对乙酰氨基酚(4人)。在22名使用者中,14人的AA凝集反应正常。所有献血者样本均显示二磷酸腺苷诱导的凝集,表明血小板完整。在报告摄入ASA或NSAIDs的献血者组与未摄入的献血者组之间,在所测试的PLT功能测定方面没有差异。

结论

得出的结论是,有相当一部分献血者在献血前使用影响血小板的药物。然而,未能确定报告的用药情况与献血者血小板功能受损之间的关系。所测试的血小板功能受损可能有除摄入ASA或NSAIDs之外的其他原因。

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