Biolik Grzegorz, Kokot Michał, Sznapka Mariola, Święszek Agnieszka, Ziaja Damian, Pawlicki Krzysztof, Ziaja Krzysztof
a Department of General Vascular Surgery, Faculty of Medicine in Katowice , School of Health Science, Medical University of Silesia , Katowice , Poland.
b Department of Internal Medicine and Metabolic Diseases, Faculty of Medicine in Katowice , School of Health Science, Medical University of Silesia , Katowice , Poland.
Scand J Clin Lab Invest. 2017 May;77(3):216-222. doi: 10.1080/00365513.2017.1292538. Epub 2017 Feb 24.
This study aimed to investigate modifications to the FIBTEM test to better assess fibrinogen levels and the quality of fibrin polymerization in citrated blood using Multiplate impedance aggregometry to verify platelet inhibition. Blood samples from 26 healthy volunteers were subjected to thromboelastometry studies (EXTEM/FIBTEM tests) in accordance with the standard study protocol (cytochalasin D) and according to a modified protocol (synthetic IIbIIIa receptor antagonist vs. acetylsalicylic acid [ASA] + synthetic IIbIIIa receptor antagonist instead of cytochalasin D). Independent of thromboelastometry, Multiplate impedance aggregometry was used to assess the degree of restriction by the platelet blocked with the following treatments: (1) cytochalasin D, (2) synthetic IIbIIIa antagonist or (3) ASA + synthetic IIbIIIa antagonist to assess the aggregation response to activation with an agonist (ADP, collagen, thrombin receptor activating peptide-6 [TRAP-6], and arachidonic acid). Via aggregometry, cytochalasin D more weakly inhibited platelet aggregation than simultaneous administration of the -IIbIIIa receptor antagonist with ASA. However, total platelet aggregation inhibition was observed after simultaneous administration of cytochalasin D combined with a synthetic IIbIIIa receptor antagonist. In the thromboelastometry, a significant decrease of the A10, A20 and MCF parameters were observed in the EXTEM/FIBTEM tests after they were modified by the addition of a synthetic IIbIIIa receptor antagonist alone or in combination with ASA. In conclusion, in this Multiplate- and ROTEM-based laboratory approach, a two-way blockade (IIbIIIa-antagonist + cytochalasine D) was sufficient to completely inhibit procoagulant platelet function as observed by aggregometry and thromboelastometry.
本研究旨在探讨对纤维蛋白原检测模板（FIBTEM）试验进行改进，以使用多电极血小板聚集仪（Multiplate）阻抗聚集法更好地评估枸橼酸盐血中纤维蛋白原水平和纤维蛋白聚合质量，从而验证血小板抑制情况。按照标准研究方案（细胞松弛素D）和改良方案（合成IIbIIIa受体拮抗剂与乙酰水杨酸[ASA]联合合成IIbIIIa受体拮抗剂，而非细胞松弛素D），对26名健康志愿者的血样进行血栓弹力图研究（EXTEM/FIBTEM试验）。独立于血栓弹力图，使用多电极血小板聚集仪评估经以下处理的血小板所产生的抑制程度：（1）细胞松弛素D，（2）合成IIbIIIa拮抗剂或（3）ASA +合成IIbIIIa拮抗剂，以评估对激动剂（二磷酸腺苷[ADP]、胶原、凝血酶受体激活肽-6[TRAP-6]和花生四烯酸）激活的聚集反应。通过聚集法，细胞松弛素D对血小板聚集的抑制作用比同时给予IIbIIIa受体拮抗剂和ASA更弱。然而，细胞松弛素D与合成IIbIIIa受体拮抗剂同时给药后观察到了完全的血小板聚集抑制。在血栓弹力图中，单独添加合成IIbIIIa受体拮抗剂或与ASA联合添加后对EXTEM/FIBTEM试验进行改良，观察到A10、A20和MCF参数显著降低。总之，在这种基于多电极血小板聚集仪和旋转血栓弹力图仪（ROTEM）的实验室方法中，双向阻断（IIbIIIa拮抗剂+细胞松弛素D）足以如通过聚集法和血栓弹力图法所观察到的那样完全抑制促凝血血小板功能。
