技术报告：用血栓弹力图分析枸橼酸盐血：与新鲜血样的比较

Technical report: analysis of citrated blood with thromboelastography: comparison with fresh blood samples.

作者信息

Wasowicz Marcin, Srinivas Coimbatore, Meineri Massimiliano, Banks Brie, McCluskey Stuart A, Karkouti Keyvan

机构信息

Department of Anesthesia, Toronto General Hospital, University Health Network, and Department of Health Policy, Management and Evaluation, University of Toronto, 200 Elizabeth St., EN3-424, Toronto, Ontario M5G 2C4, Canada.

出版信息

Can J Anaesth. 2008 May;55(5):284-9. doi: 10.1007/BF03017205.

DOI:10.1007/BF03017205

PMID:18451116

Abstract

PURPOSE

Thromboelastography (TEG) evaluates the visco-elastic properties of whole blood to assess clot formation and hemostasis. When blood cannot be analyzed immediately, it is stored in citrated tubes to be analyzed after recalcification. In this study, we evaluated the results of TEG analysis performed on citrated blood and compared these results to values obtained from activated (kaolin and tissue factor) and non activated, fresh blood samples, obtained at various time intervals (one, two, and three hours).

METHODS

Four blood samples were collected from each of ten healthy volunteers. The following TEG analyses were performed on each sample: reaction time (r), k time (k), alpha angle (alpha), and maximum amplitude (MA). Studies were done using fresh, non citrated blood, obtained within five minutes of collection, and using citrated blood, one, two, and three hours after collection. Samples were analyzed, with and without activation, using kaolin and tissue factor.

RESULTS

Tissue factor activated and non activated, citrated samples had shorter r and k times (P=0.03, P=0.008, P<0.0001, and P<0.0001, respectively) and higher alpha angle and MA values (P<0.0001, P<0.0001, P=0.79, and P=0.03, respectively) compared to fresh, non citrated samples. These findings were consistent with a hypercoagulable state. Conversely, citrated samples, activated with kaolin, yielded results similar to those obtained from fresh, non citrated samples. The TEG measurements were similar among citrated samples stored from one to three hours.

CONCLUSIONS

Our results demonstrate that TEG measures, performed on citrated blood samples, yield results that are consistent with a hyperocoagulable state. Using kaolin to activate citrated samples, on the other hand, yields results similar to those obtained from non citrated, fresh blood samples.

摘要

目的

血栓弹力图（TEG）评估全血的粘弹性特性，以评估凝血形成和止血情况。当血液无法立即分析时，将其储存在枸橼酸盐管中，重新钙化后进行分析。在本研究中，我们评估了对枸橼酸盐血进行TEG分析的结果，并将这些结果与在不同时间间隔（1小时、2小时和3小时）获得的活化（高岭土和组织因子）及未活化的新鲜血样的值进行比较。

方法

从10名健康志愿者中每人采集4份血样。对每份样品进行以下TEG分析：反应时间（r）、k时间（k）、α角（α）和最大振幅（MA）。研究使用采集后5分钟内获得的新鲜、未枸橼酸化的血液，以及采集后1小时、2小时和3小时的枸橼酸盐血。使用高岭土和组织因子对样品进行有或无活化的分析。

结果

与新鲜、未枸橼酸化的样品相比，组织因子活化和未活化的枸橼酸盐样品的r和k时间较短（分别为P = 0.03、P = 0.008、P < 0.0001和P < 0.0001），α角和MA值较高（分别为P < 0.0001、P < 0.0001、P = 0.79和P = 0.03）。这些发现与高凝状态一致。相反，用高岭土活化的枸橼酸盐样品产生的结果与新鲜、未枸橼酸化的样品相似。在1至3小时储存的枸橼酸盐样品中，TEG测量结果相似。