Saleem A, Blifeld C, Saleh S A, Yawn D H, Mace M L, Schwartz M, Crawford E S
Ann Clin Lab Sci. 1983 Mar-Apr;13(2):115-24.
Assessment of platelet function presents a challenge to the investigators in the clinical field. An instrument, Sonoclot, is described which measures changes in the viscoelastic properties (clot impedance on a vibrating probe) of plasma as it is recalcified. Platelet poor plasma (PPP) and platelet rich plasma (PRP) show distinct and characteristic Sonoclot tracings. Tracings of PPP show a lag period and a primary wave. These parameters correspond to recalcification time and fibrin polymerization. Tracings of PRP show, in addition, a secondary wave and a downward wave. These parameters correspond to the incorporation of platelets in the clot and retraction of the clot. The PRP parameters are influenced by the number and quality of the platelets. This instrument was utilized to assess the platelet function in patients after coronary artery bypass surgery (CAB). In 69 patients studied, 20 patients did not have excessive bleeding. The clot impedance tracings in this group were normal. Twenty-four patients had excessive bleeding, normal clot impedance, and coagulation tests indicating the possibility of surgical bleeding. This was confirmed in 22 (92 percent) patients upon exploration to control bleeding. Twenty-five patients had excessive bleeding, normal coagulation tests and abnormal clot impedance suggesting platelet dysfunction. In twenty-one (84 percent) of the patients, transfusion of platelet concentrate controlled the bleeding with corresponding correction of clot impedance. Sonoclot studies are quick and easy to perform, and appear to be a valuable and reliable adjunct in the diagnosis of hemostatic problems after CAB surgery.
血小板功能评估给临床领域的研究人员带来了挑战。本文介绍了一种名为Sonoclot的仪器，它可测量血浆重新钙化时粘弹性特性（振动探头上的凝块阻抗）的变化。贫血小板血浆（PPP）和富血小板血浆（PRP）呈现出独特且具有特征性的Sonoclot描记图。PPP的描记图显示出一个延迟期和一个初级波。这些参数分别对应重新钙化时间和纤维蛋白聚合。PRP的描记图还显示出一个次级波和一个下降波。这些参数分别对应血小板在凝块中的整合以及凝块的回缩。PRP参数受血小板数量和质量的影响。该仪器被用于评估冠状动脉搭桥手术（CAB）后患者的血小板功能。在研究的69例患者中，20例没有过度出血。该组的凝块阻抗描记图正常。24例患者有过度出血，凝块阻抗正常，凝血试验提示可能存在手术出血。在22例（92%）患者中，经探查控制出血后证实了这一点。25例患者有过度出血，凝血试验正常但凝块阻抗异常，提示血小板功能障碍。在21例（84%）患者中，输注血小板浓缩物控制了出血，同时凝块阻抗得到相应纠正。Sonoclot研究操作快速简便，似乎是CAB手术后止血问题诊断中有价值且可靠的辅助手段。
