Department of Hematology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Vox Sang. 2010 Aug 1;99(2):123-30. doi: 10.1111/j.1423-0410.2010.01337.x. Epub 2010 Apr 23.
As thrombelastography (TEG) measures haemostasis in whole blood, we used this instrument to study whether transfused platelets (PLTs) have the same haemostatic function compared to native circulating PLTs. Further, we studied the effect of storage time on the haemostatic potential of platelet concentrates (PCs).
During the decrease in PLT count after chemotherapy, TEG parameters were measured serially until the transfusion trigger was reached in 92 patients. TEG parameters for different ranges of native circulating PLTs could be assessed, which were compared to ranges obtained in the thrombocytopenic period in which the patient received PLT transfusions. Finally, we compared the haemostatic potential of fresh PCs (1-3 days) with PCs with longer storage time (4-5 days).
No differences could be found in haemostatic potential between native PLTs and transfused stored PLTs (all P-values > or = 0.1). The transfusion of fresh PLTs demonstrated better haemostatic effects than longer stored PLTs, measured 1 h after transfusion. Both the time until a fixed level of clot firmness was reached (K-time) and the rate of clot growth (alpha angle) were superior for fresh PCs.
TEG is able to monitor the haemostatic effects of PLT transfusion, with comparable haemostatic properties of native circulating and transfused stored-PLTs. Further, our data suggest that limited storage time is associated with a better haemostatic capacity. However, before TEG can be applied as a qualitative test in PLT transfusion, further research is needed with focus on clinical outcomes like bleeding episodes.
由于血栓弹力图（TEG）可以测量全血的止血功能，因此我们使用该仪器研究输注的血小板（PLT）与循环中的天然 PLT 是否具有相同的止血功能。此外，我们研究了储存时间对血小板浓缩物（PC）止血潜力的影响。
在化疗后血小板计数下降期间，对 92 例患者进行了 TEG 参数的连续测量，直到达到输血触发值。可以评估不同范围的天然循环 PLT 的 TEG 参数，并将其与患者接受 PLT 输注时血小板减少期获得的范围进行比较。最后，我们比较了新鲜 PC（1-3 天）与储存时间较长的 PC（4-5 天）的止血潜力。
天然 PLT 和输注储存的 PLT 之间的止血潜力没有差异（所有 P 值均>或=0.1）。与储存时间较长的 PLT 相比，输注新鲜 PLT 在输血后 1 小时显示出更好的止血效果。达到固定凝块硬度水平所需的时间（K 时间）和凝块生长速度（α 角）均优于新鲜 PC。
TEG 能够监测 PLT 输注的止血效果，天然循环和输注储存的 PLT 具有相似的止血特性。此外，我们的数据表明，有限的储存时间与更好的止血能力相关。然而，在 TEG 可作为 PLT 输注的定性测试之前，还需要进一步研究，重点关注出血事件等临床结局。
