Hussey C V, Hause L L, Gottschall J L, Anderson T
Thromb Res. 1986 Nov 1;44(3):355-64. doi: 10.1016/0049-3848(86)90010-1.
A factor capable of aggregating normal platelets was found in the plasma of six consecutive patients with thrombotic thrombocytopenic purpura (TTP). The activity of the aggregating factor in whole plasma, the cold protein fraction from plasma and the residual supernatant was monitored during each patient's course of therapeutic plasma exchange. Although two patients demonstrated the highest level of aggregating activity at the time of diagnosis, the level fluctuated in five of six patients. Increasing levels of activity were usually accompanied by signs of clinical deterioration. Activity repeatedly within the normal range was not seen until remission of the syndrome. Neutralization of the aggregating activity in vivo through removal of patient plasma and replacement with fresh frozen plasma (plasma exchange) was accomplished less readily and less predictably than by mixing patient plasma and normal plasma in vitro. Use of the aggregating factor level in evaluating the need of plasma exchange is discussed.
在连续六例血栓性血小板减少性紫癜（TTP）患者的血浆中发现了一种能够使正常血小板聚集的因子。在每位患者进行治疗性血浆置换的过程中，监测了全血浆、血浆冷蛋白组分和残余上清液中聚集因子的活性。尽管两名患者在诊断时显示出最高水平的聚集活性，但六名患者中有五名患者的活性水平出现波动。活性水平升高通常伴随着临床病情恶化的迹象。直到综合征缓解，才反复出现活性在正常范围内的情况。通过去除患者血浆并用新鲜冷冻血浆替代（血浆置换）在体内中和聚集活性，其完成过程比在体外将患者血浆与正常血浆混合更不容易且更难以预测。讨论了使用聚集因子水平评估血浆置换需求的情况。
