Escolar G, Garrido M, Mazzara R, Castillo R, Ordinas A
Servicio de Hemoterapia y Hemostasia, Hospital Clinic i Provincial, Barcelona, Spain.
Transfusion. 1988 Sep-Oct;28(5):406-11. doi: 10.1046/j.1537-2995.1988.28588337325.x.
The Baumgartner perfusion technique was used as an experimental model to study the combined influence of red cell (RBC) and platelet counts on the interaction of platelets with the subendothelium. At normal hematocrit and a platelet count of 100,000 per microliter, platelet adhesion and platelet aggregate (PAG) formation on subendothelium were statistically decreased. At lower platelet counts (50,000/microliter), there was an even more marked reduction in the formation of PAGs. The critical role of RBCs was demonstrated in experiments at low hematocrit; the formation of PAGs was impaired in perfusions at 20 percent hematocrit at any platelet count tested. Platelet deposition on subendothelium was almost absent at 50,000 platelets per microliter, suggesting a negative synergistic effect for the association of low hematocrit (20%) with a low platelet count. Perfusion experiments carried out with nonanticoagulated blood drawn directly from anemic patients with mild thrombocytopenia (43,000-58,000 platelets/microliter) before and after RBC transfusion were in agreement with previous experiments that indicated that normalization of both platelet count and hematocrit is required to achieve optimum hemostasis. Our data give experimental support for the transfusional management of patients with anemia and thrombocytopenia.
采用鲍姆加特纳灌注技术作为实验模型，以研究红细胞（RBC）计数和血小板计数对血小板与内皮下层相互作用的联合影响。在正常血细胞比容和每微升100,000的血小板计数时，内皮下层的血小板黏附和血小板聚集体（PAG）形成在统计学上有所减少。在较低的血小板计数（每微升50,000）时，PAG形成的减少更为明显。在低血细胞比容的实验中证明了红细胞的关键作用；在任何测试的血小板计数下，血细胞比容为20%时的灌注中PAG形成受损。每微升50,000个血小板时，内皮下层几乎没有血小板沉积，这表明低血细胞比容（20%）与低血小板计数之间存在负协同效应。对轻度血小板减少（43,000 - 58,000个血小板/微升）的贫血患者直接抽取的未抗凝血液在输血前后进行的灌注实验与先前的实验一致，表明血小板计数和血细胞比容均需恢复正常才能实现最佳止血。我们的数据为贫血和血小板减少患者的输血管理提供了实验支持。
