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高剂量抗凝血酶对血小板功能和血液凝固的影响。

Influence of high-dose antithrombin on platelet function and blood coagulation.

作者信息

Miike Toru, Sakamoto Yuichiro, Narumi Shougo, Yoshitake Kunimasa, Sakurai Ryota, Nakayama Kento, Inoue Satoshi

机构信息

Department of Emergency and Critical Care Medicine Faculty of Medicine Saga University Saga City Japan.

出版信息

Acute Med Surg. 2021 May 1;8(1):e648. doi: 10.1002/ams2.648. eCollection 2021 Jan-Dec.

Abstract

AIM

In healthy adults, there are sufficient amounts of antithrombin in the blood to regulate thrombin. However, the effects of high concentrations of antithrombin on dose-dependent anticoagulation and platelet function have not been reported. In this study, we assessed platelet function and blood coagulation following high-dose antithrombin supplementation .

METHODS

Blood samples were collected from 10 healthy volunteers, and samples with different antithrombin concentrations were prepared by adding an antithrombin agent (Neuart). Blood coagulation was assessed by the Thrombus-Formation Analysis System (T-TAS) and Rotational Thromboelastometry (ROTEM) using whole blood samples.

RESULTS

The data obtained by the platelet chip, exclusively representing platelet function, revealed that the onset of thrombus formation was significantly delayed in a dose-dependent manner (100%-200%,  = 0.021; 100%-500%,  = 0.011; 200%-500%,  = 0.047). In measurements using the atheroma chip, which enables assessment of blood coagulation, the thrombus formation ability was found to be reduced (100%-200%,  = 0.022; 100%-500%,  = 0.05). In the ROTEM measurements, clotting time was prolonged in a dose-dependent manner (100%-200%:  = 0.203, 200%-500%:  = 0.005, 500%-1000%:  = 0.022), except when comparing with 100% and 200%. Although antithrombin is reportedly saturated in healthy blood, its anticoagulant ability appears to be enhanced depending on its concentration. Furthermore, data obtained from the platelet chip showed that antithrombin might reduce platelet function.

CONCLUSIONS

Antithrombin suppressed platelet function and blood coagulation in a dose-dependent manner.

摘要

目的

在健康成年人中,血液中有足够量的抗凝血酶来调节凝血酶。然而,高浓度抗凝血酶对剂量依赖性抗凝和血小板功能的影响尚未见报道。在本研究中,我们评估了高剂量补充抗凝血酶后的血小板功能和血液凝固情况。

方法

从10名健康志愿者采集血样,通过添加抗凝血酶制剂(Neuart)制备不同抗凝血酶浓度的样本。使用全血样本通过血栓形成分析系统(T-TAS)和旋转血栓弹力图(ROTEM)评估血液凝固情况。

结果

仅代表血小板功能的血小板芯片获得的数据显示,血栓形成的起始以剂量依赖性方式显著延迟(100% - 200%,P = 0.021;100% - 500%,P = 0.011;200% - 500%,P = 0.047)。在使用能够评估血液凝固的动脉粥样硬化芯片进行的测量中,发现血栓形成能力降低(100% - 200%,P = 0.022;100% - 500%,P = 0.05)。在ROTEM测量中,凝血时间以剂量依赖性方式延长(100% - 200%:P = 0.203,200% - 500%:P = 0.005,500% - 1000%:P = 0.022),与100%和200%比较时除外。尽管据报道在健康血液中抗凝血酶已饱和,但其抗凝能力似乎随浓度增加而增强。此外,从血小板芯片获得的数据表明抗凝血酶可能会降低血小板功能。

结论

抗凝血酶以剂量依赖性方式抑制血小板功能和血液凝固。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e83/8088397/9ff77cf6c02b/AMS2-8-e648-g005.jpg

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