Department of Medicine, McMaster University, Hamilton, Canada.
Am J Clin Pathol. 2011 Sep;136(3):350-8. doi: 10.1309/AJCP9IPR1TFLUAGM.
Platelet dense granule release assays are recommended for diagnosing platelet function disorders and are commonly performed by Lumi-Aggregometer (Chrono-Log, Havertown, PA) assays of adenosine triphosphate (ATP) release. We conducted a prospective cohort study of people tested for ATP release defects to assess bleeding symptoms. Reduced release, with 1 or more agonists, was more common among patients with bleeding disorders than among healthy control subjects (P < .001). The respective likelihood (odds ratio [95% confidence interval]) of a bleeding disorder or an inherited platelet function disorder were high when release was reduced with 1 or more agonists (17 [6-46]; 128 [30-545]), even if aggregation was normal (12 [4-34]; 105 [20-565]). ATP release had high specificity and moderate sensitivity for inherited platelet function disorders, with most abnormalities detected by the combination of 6 μmol/L epinephrine, 5.0 μg/mL collagen, and 1 μmol/L U46619. Platelet ATP release assays are useful for evaluating common bleeding disorders, regardless of aggregation findings.
血小板致密颗粒释放试验被推荐用于诊断血小板功能障碍，通常通过 Lumi-Aggregometer（Chrono-Log，Havertown，PA）测定三磷酸腺苷（ATP）释放来进行。我们对接受 ATP 释放缺陷检测的人群进行了一项前瞻性队列研究，以评估出血症状。与健康对照组相比，具有出血性疾病的患者中存在 1 种或多种激动剂的释放减少更为常见（P＜.001）。当 1 种或多种激动剂诱导的释放减少时，发生出血性疾病或遗传性血小板功能障碍的可能性（比值比[95%置信区间]）较高（17 [6-46]；128 [30-545]），即使聚集正常（12 [4-34]；105 [20-565]）。ATP 释放对遗传性血小板功能障碍具有较高的特异性和中等的敏感性，大多数异常通过 6 μmol/L 肾上腺素、5.0 μg/mL 胶原和 1 μmol/L U46619 的联合检测来发现。无论聚集结果如何，血小板 ATP 释放试验对于评估常见出血性疾病都很有用。
