Wei Hai-Yan, Ding Zheng-Nian, Shi Hong-Wei, Ge Ya-Li, Chen Xin
Department of Anesthesiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, Jiangsu Province, China.
Department of Anesthesiology, The First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, Jiangsu Province, China. E-mail:
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2014 Apr;22(2):521-4. doi: 10.7534/j.issn.1009-2137.2014.02.047.
This study was aimed to evaluate the efficiency and effectiveness of platelet-rich plasma(PRP) prepared by acute plateletpheresis in patients undergoing open heart surgery, and to analyze the quality of prepared platelet-rich plasma. Whole blood from 20 patients with ASAII-III was collected and PRP was harvested by machine after induction of anesthesia. Platelet count (Plt), mean platelet volume (MPV), platelet distribution width (PDW), plasma pH, plasma lactic acid (LA) concentration, and lactic dehydrogenase (LDH) concentration, germiculture result, CD62p and PAC-1 positive rate of inactivated and activated platelets by ADP in the whole blood before plateletpheresis (T1) , in the PRP after plateletpheresis (T2) and PRP before back-transfusion (T3) were determinated. The results showed that as compared with whole blood the platelet count in the PRP at T2 was (783 ± 184) ×10(9)/L, MPV, PDW and pH significantly decreased (P < 0.01) , while the plasma LDH, LA concentration, CD62p and PAC-1 positive rate of inactivated platelets were not significantly different from the whole blood at T1. In the PRP at T3, the platelet count, MPV, PDW and pH significantly decreased (P < 0.01) , while plasma LDH concentration, CD62p and PAC-1 positive rate of inactivated platelet significantly increased (P < 0.05 or P < 0.01) compared with the whole blood at T1. There were no significant difference among the CD62p and PAC-1 positive rate of activated platelets in the whole blood and PRP. It is concluded that PRP can be efficiently obtained from the patients undergoing open heart surgery by acute plateletpheresis, and the platelets in PRP are not activated during the preparing process. Some platelets in PRP are activated during the preserving process, but the whole activating function of platelets keeps normal.
本研究旨在评估急性血小板分离术制备的富血小板血浆（PRP）在心脏直视手术患者中的效率和效果，并分析所制备富血小板血浆的质量。收集20例ASAII-III级患者的全血，麻醉诱导后通过机器采集PRP。测定血小板分离术前全血（T1）、血小板分离术后PRP（T2）和回输前PRP（T3）中的血小板计数（Plt）、平均血小板体积（MPV）、血小板分布宽度（PDW）、血浆pH值、血浆乳酸（LA）浓度、乳酸脱氢酶（LDH）浓度、细菌培养结果、CD62p和ADP激活前后全血及PRP中PAC-1阳性率。结果显示，与全血相比，T2时PRP中的血小板计数为（783±184）×10⁹/L，MPV、PDW和pH值显著降低（P<0.01），而血浆LDH、LA浓度、CD62p和未激活血小板的PAC-1阳性率与T1时的全血无显著差异。T3时PRP中的血小板计数、MPV、PDW和pH值显著降低（P<0.01），而与T1时的全血相比，血浆LDH浓度、CD62p和未激活血小板的PAC-1阳性率显著升高（P<0.05或P<0.01）。全血和PRP中激活血小板的CD62p和PAC-1阳性率无显著差异。结论：通过急性血小板分离术可从心脏直视手术患者中高效获取PRP，且PRP中的血小板在制备过程中未被激活。PRP中的部分血小板在保存过程中被激活，但血小板的整体激活功能保持正常。
