Mazzara R, Escolar G, Garrido M, Pereira A, Castillo R, Ordinas A
Servicio de Hemoterapia y Hemostasia, Hospital Clínico y Provincial, Facultad de Medicina, Universidad de Barcelona, Spain.
Transfusion. 1991 May;31(4):308-12. doi: 10.1046/j.1537-2995.1991.31491213293.x.
An in vitro perfusion technique was used for the assessment of the effectiveness of platelet concentrates (PCs) administered to patients with bone marrow failure. Denuded rabbit arterial segments mounted in annular chambers were exposed to nonanticoagulated blood drawn directly from the antecubital vein. This perfusion system allows the direct visualization of platelet-subendothelium interactions. The deposition of platelets on exposed subendothelium and the presence of fibrin were evaluated morphometrically. Perfusions were performed before and 10 and 120 minutes after the transfusion of PCs that had been obtained by apheresis and administered immediately after collection (A) or separated by centrifugation of blood units and transfused 24 hours after storage at 22 degrees C (B) or 4 degrees C (C). Bleeding times were also determined systematically. The deposition of platelets on the subendothelium increased significantly (p less than 0.01) 10 minutes after transfusions of A and B PCs, but the presence of fibrin did not differ from pretransfusion values. Two hours after the administration of A or B PCs, the improvement of platelet deposition persisted. By then, the presence of fibrin increased markedly (p less than 0.01). The deposition of platelets was not modified after the transfusion of C PCs, but the presence of fibrin was augmented significantly at both posttransfusion times. Comparisons between bleeding times and morphometric results pointed to a possible role of fibrin formation in contributing to primary hemostasis.
采用体外灌注技术评估血小板浓缩物（PCs）对骨髓衰竭患者的疗效。将剥脱内皮的兔动脉段置于环形腔室中，暴露于直接从前臂静脉抽取的未抗凝血液。该灌注系统可直接观察血小板与内皮下的相互作用。采用形态学方法评估血小板在内皮暴露表面的沉积情况以及纤维蛋白的存在情况。在输注通过单采获得并在采集后立即输注的PCs（A组），或通过离心血液单位分离并在22℃储存24小时后输注的PCs（B组），或在4℃储存24小时后输注的PCs（C组）之前、之后10分钟和120分钟进行灌注。还系统地测定了出血时间。输注A组和B组PCs后10分钟，血小板在内皮下的沉积显著增加（p<0.01），但纤维蛋白的存在情况与输血前值无差异。输注A组或B组PCs两小时后，血小板沉积的改善持续存在。此时，纤维蛋白的存在显著增加（p<0.01）。输注C组PCs后血小板沉积未改变，但在两个输血后时间点纤维蛋白的存在均显著增加。出血时间与形态学结果的比较表明纤维蛋白形成在初级止血中可能起作用。
