Institute of Inflammation and Ageing, University of Birmingham, Edgbaston, Birmingham, UK.
Institute of Cardiovascular Sciences University of Birmingham, University of Birmingham, Edgbaston, Birmingham, UK.
J Thromb Haemost. 2017 Oct;15(10):2045-2052. doi: 10.1111/jth.13784. Epub 2017 Sep 13.
Essentials There is a clinical need for new technologies to measure platelet function in whole blood. Mild bleeding disorders were evaluated using multiple electrode aggregometry (MEA). MEA is insensitive at detecting patients with mild platelet function and secretion defects. More studies are required to investigate MEA in patients with a defined set of platelet disorders.
Background Multiple electrode aggregometry (MEA) measures changes in electrical impedance caused by platelet aggregation in whole blood. This approach is faster, more convenient and offers the advantage over light transmission aggregometry (LTA) of assessing platelet function in whole blood and reducing preanalytical errors associated with preparation of platelet-rich plasma (PRP). Several studies indicate the utility of this method in assessing platelet inhibition in individuals taking antiplatelet agents (e.g. aspirin and clopidogrel). Objective Our current study sought to evaluate the ability of MEA in diagnosing patients with mild bleeding disorders by comparison with light transmission lumi-aggregometry (lumi-LTA). Methods Forty healthy subjects and 109 patients with a clinical diagnosis of a mild bleeding disorder were recruited into the UK Genotyping and Phenotyping of Platelets study (GAPP, ISRCTN 77951167). MEA was performed on whole blood using one or two concentrations of ADP, PAR-1 peptide, arachidonic acid and collagen. Lumi-LTA was performed in PRP using several concentrations of ADP, adrenaline, arachidonic acid, collagen, PAR-1 peptide and ristocetin. Results Of 109 patients tested, 54 (49%) patients gave abnormal responses by lumi-LTA to one or more agonists. In contrast, only 16 (15%) patients were shown to have abnormal responses to one or more agonists by MEA. Conclusions In this study we showed that MEA is less sensitive in identifying patients with abnormal platelet function relative to lumi-LTA.
要点 临床需要新的技术来测量全血中的血小板功能。使用多个电极聚集仪（MEA）评估轻度出血性疾病。MEA 对检测轻度血小板功能和分泌缺陷的患者不敏感。需要更多的研究来调查 MEA 在具有明确一组血小板疾病的患者中的应用。
背景 多个电极聚集仪（MEA）测量全血中血小板聚集引起的电阻抗变化。这种方法更快、更方便，与光传输聚集仪（LTA）相比，它具有评估全血中血小板功能和减少与富含血小板血浆（PRP）制备相关的分析前误差的优势。几项研究表明，这种方法在评估服用抗血小板药物（如阿司匹林和氯吡格雷）的个体的血小板抑制作用方面具有实用性。
目的 我们目前的研究旨在通过与光传输发光聚集仪（lumi-LTA）比较，评估 MEA 诊断轻度出血性疾病患者的能力。
方法 英国基因分型和血小板表型研究（GAPP，ISRCTN77951167）招募了 40 名健康受试者和 109 名临床诊断为轻度出血性疾病的患者。使用 ADP、PAR-1 肽、花生四烯酸和胶原的一个或两个浓度在全血中进行 MEA。在 PRP 中使用 ADP、肾上腺素、花生四烯酸、胶原、PAR-1 肽和瑞斯托菌素的几种浓度进行 lumi-LTA。
结果 在 109 名测试的患者中，54 名（49%）患者对一种或多种激动剂的 lumi-LTA 反应异常。相比之下，只有 16 名（15%）患者被证明对一种或多种激动剂的 MEA 反应异常。
结论 在这项研究中，我们表明 MEA 在识别具有异常血小板功能的患者方面不如 lumi-LTA 敏感。
