Equine Clinic, Internal Medicine, Department of Veterinary Clinical Science, Justus Liebig University, Giessen, Germany.
Clinical Pathophysiology and Veterinary Clinical Pathology, Department of Veterinary Clinical Science, Justus Liebig University, Giessen, Germany.
J Vet Diagn Invest. 2021 Mar;33(2):300-307. doi: 10.1177/1040638720983791. Epub 2020 Dec 22.
In addition to maintaining hemostasis, platelets have an important role in modulating innate and adaptive immune responses. A low platelet count has been found to be a negative prognostic factor for survival in humans and horses with critical illnesses, such as sepsis or systemic inflammatory response syndrome (SIRS). Decreased platelet aggregation, caused by in vivo activation, has been found in human patients with severe sepsis. In our prospective controlled study, we assessed platelet biology in blood samples from 20 equine SIRS cases and 120 healthy control horses. Platelet variables such as platelet count, large platelet count, clumps, plateletcrit, mean platelet volume, and mean platelet component concentration were analyzed by laser flow cytometry (Advia 2120) from KEDTA blood and from citrate blood. Hirudin blood samples were analyzed by impedance aggregometry (Multiplate analyzer; Roche) for platelet aggregation, including spontaneous aggregation and aggregation by 4 different agonists: adenosine diphosphate (ADPtest), ADP + prostaglandin E1 (ADPtestHS), arachidonic acid (ASPItest), and collagen (COLtest). SIRS cases had significantly lower platelet counts in KEDTA blood ( < 0.0001) compared to control horses. There were no significant differences in aggregation values between SIRS cases and controls. Non-surviving SIRS horses did not have statistically significant lower platelet counts or lower aggregation values for COLtest, ADPtest, or ADPtestHS compared to surviving SIRS horses, although 5 non-survivors were thrombocytopenic.
除了维持止血作用外，血小板在调节先天和适应性免疫反应方面也起着重要作用。研究发现，血小板计数低是患有脓毒症或全身性炎症反应综合征（SIRS）等危重病人类和马的生存的负性预后因素。在严重脓毒症的人类患者中发现，由于体内激活导致血小板聚集减少。在我们的前瞻性对照研究中，我们评估了 20 例马 SIRS 病例和 120 例健康对照马的血液样本中的血小板生物学。通过激光流式细胞术（Advia 2120）分析 KEDTA 血液和柠檬酸盐血液中的血小板变量，如血小板计数、大血小板计数、血小板聚集物、血小板crit、平均血小板体积和平均血小板成分浓度。使用阻抗聚集仪（Multiplate 分析仪；罗氏）分析肝素化血液样本中的血小板聚集，包括自发性聚集和 4 种不同激动剂（ADP 测试、ADP +前列腺素 E1（ADPtestHS）、花生四烯酸（ASPItest）和胶原（COLtest）的聚集。与对照组相比，SIRS 病例的 KEDTA 血液中的血小板计数明显降低（<0.0001）。SIRS 病例和对照组之间的聚集值没有显著差异。与存活的 SIRS 马相比，非存活的 SIRS 马的 COLtest、ADPtest 或 ADPtestHS 的血小板计数或聚集值没有统计学意义上的降低，尽管有 5 例非存活者血小板减少。
