Fuchs J, Joshua H, Weinberger I, Rotenberg Z, Davidson E, Agmon J
Department of Medicine A, Beilinson Medical Center, Petah Tikva, Israel.
Arch Pathol Lab Med. 1990 Jan;114(1):43-9.
A method for the quantitative and qualitative determination of the number of aggregated platelets is described. One milliliter of venous blood was separated equally into two solutions. One solution composed of EDTA (ethylenediaminetetraacetic acid) and formaldehyde (solution F) contained reversibly and irreversibly aggregated platelets, and the second solution, composed of EDTA alone (solution E), contained irreversibly aggregated platelets. By microscopic readings, the percentage of platelets forming aggregates was determined. Reversibly aggregated platelets were estimated by subtracting the percentage of aggregated platelets in solution E from that in solution F. The average amount of platelets per aggregate was calculated by dividing the number of aggregated platelets in solution F by the number of aggregates per 1000 platelets counted. The reference ranges (means +/- SDs) established in 100 healthy persons were 5.8% +/- 2.4% (1% to 9%) for solution F, 3.9% +/- 1.8% (0% to 7%) for solution E, and 2.2 +/- 0.18 (2.0 to 2.5) for the average number of platelets per aggregate. Twenty hospitalized patients without heart disease had values similar to those of 100 normal subjects. In 50 patients with acute myocardial infarction, the percentage of aggregated platelets in solution F was 23.8% +/- 10.3%; in solution E, 4.0% +/- 3.0%; and the average number of platelets per aggregate, 2.9 +/- 0.7. The mean variance for five daily consecutive measurements was 0.52% for solution F, 0.63% for solution E, and 0.002 for the average number of platelets per aggregate. An even lesser mean variance was observed when the interobserver-vs-intraobserver and the intersmear-vs-intrasmear variations were tested. In patients with acute myocardial infarction, the interobserver-vs-intraobserver variance was 5.6% for solution F, 2.2% for solution E, and 0.005 for the average number of platelets per aggregate. The parameters studied were unaffected by different blood drawings, assay tubes, or venous stasis. In 80 patients with unstable angina, the studied parameters as well as the percentage of "big" platelets were measured on hospital days 1, 2, and 5. In 25 patients in whom acute myocardial infarction developed during hospitalization, the percentage of aggregated platelets was 28.1% +/- 8.3%. Most of them (71%) were reversibly aggregated and did not change during hospitalization. The average number of platelets per aggregate was 3.9 +/- 1.6, and the percentage of big platelets was 12.5% +/- 7.2%, both values not undergoing subsequent changes. In patients in whom acute myocardial infarction did not develop, the percentage of aggregated platelets decreased to 14.2% +/- 6.1% on day 5. Most aggregated platelets (58.8% to 90%) were irreversibly aggregated.(ABSTRACT TRUNCATED AT 400 WORDS)
本文描述了一种定量和定性测定聚集血小板数量的方法。将1毫升静脉血等分为两种溶液。一种由乙二胺四乙酸（EDTA）和甲醛组成的溶液（溶液F）含有可逆和不可逆聚集的血小板，另一种仅由EDTA组成的溶液（溶液E）含有不可逆聚集的血小板。通过显微镜读数，测定形成聚集体的血小板百分比。可逆聚集的血小板通过从溶液F中聚集血小板的百分比减去溶液E中聚集血小板的百分比来估算。每个聚集体中血小板的平均数量通过将溶液F中聚集血小板的数量除以每1000个计数血小板中的聚集体数量来计算。在100名健康人中建立的参考范围（均值±标准差）为：溶液F为5.8%±2.4%（1%至9%），溶液E为3.9%±1.8%（0%至7%），每个聚集体中血小板的平均数量为2.2±0.18（2.0至2.5）。20名无心脏病的住院患者的值与100名正常受试者的值相似。在50名急性心肌梗死患者中，溶液F中聚集血小板的百分比为23.8%±10.3%；溶液E中为4.0%±3.0%；每个聚集体中血小板的平均数量为2.9±0.7。连续5天每日测量的平均方差为：溶液F为0.52%，溶液E为0.63%，每个聚集体中血小板的平均数量为0.002。在测试观察者间与观察者内以及涂片间与涂片内的差异时，观察到的平均方差甚至更小。在急性心肌梗死患者中，观察者间与观察者内的方差为：溶液F为5.6%，溶液E为2.2%，每个聚集体中血小板的平均数量为0.005。所研究的参数不受不同采血方式、测定管或静脉淤滞的影响。在80名不稳定型心绞痛患者中，在住院第1天、第2天和第5天测量了所研究的参数以及“大”血小板的百分比。在25名住院期间发生急性心肌梗死的患者中，聚集血小板的百分比为28.1%±8.3%。其中大多数（71%）是可逆聚集的，在住院期间没有变化。每个聚集体中血小板的平均数量为3.9±1.6，大血小板的百分比为12.5%±7.2%，这两个值随后均未发生变化。在未发生急性心肌梗死的患者中，第5天聚集血小板的百分比降至14.2%±6.1%。大多数聚集血小板（58.8%至90%）是不可逆聚集的。（摘要截断于400字）
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