Carr M E, Carr S L
Department of Medicine, Medical of Virginia, Richmond, USA.
Blood Coagul Fibrinolysis. 1995 Feb;6(1):79-86. doi: 10.1097/00001721-199502000-00013.
During clot retraction, platelets interact with fibrin resulting in marked reduction of clot volume. Altered fibrin structure has been reported to affect clot retraction as measured by serum expression. This study was performed to test whether such altered retraction was the result of increased resistance to network collapse or due to decreased force development by platelets. Altered fibrin structure was documented as variation of fibre mass/length ratios (mu) and shifts in clot elastic modulus. The force developed by platelets during clotting was measured directly. Increasing the fibrinogen concentration led to thinner fibre formation (decreased mu), and a linear increase in gel elastic modulus. Over a fibrinogen concentration range of 100 to 400 mg/dl, force development was minimally affected. Force development and clot elastic modulus increased in a linear fashion with increasing platelet concentration. Increasing the calcium concentration from 5 to 20 mM caused a 160% increase in fibrin fibre size (mu), and a 52% decline in clot modulus. Force developed at 1200 s declined by 17%. At 15 mg/ml, dextran and hydroxyethyl starch (HES) also increased mu, and decreased clot modulus; however, both agents markedly reduced force development. Increasing ionic strength or the addition of IgG decreased mu and increased gel elastic modulus. Force development increased modestly with increased ionic strength, did not change with addition of IgG in saline and declined with addition of IgG in maltose. This study indicates that force development is primarily dependent on platelet function while clot modulus depends on both fibrin structure and platelet function.(ABSTRACT TRUNCATED AT 250 WORDS)
在凝块回缩过程中,血小板与纤维蛋白相互作用,导致凝块体积显著减小。据报道,纤维蛋白结构改变会影响通过血清表达测量的凝块回缩。本研究旨在测试这种回缩改变是由于对网络塌陷的抵抗力增加还是由于血小板产生的力降低所致。纤维蛋白结构改变表现为纤维质量/长度比(μ)的变化和凝块弹性模量的改变。直接测量血小板在凝血过程中产生的力。增加纤维蛋白原浓度会导致形成更细的纤维(μ降低),凝胶弹性模量呈线性增加。在100至400mg/dl的纤维蛋白原浓度范围内,力的产生受到的影响最小。力的产生和凝块弹性模量随血小板浓度增加呈线性增加。将钙浓度从5mM增加到20mM会导致纤维蛋白纤维大小(μ)增加160%,凝块模量下降52%。在1200秒时产生的力下降了17%。在15mg/ml时,右旋糖酐和羟乙基淀粉(HES)也增加了μ,并降低了凝块模量;然而,这两种试剂都显著降低了力的产生。增加离子强度或添加IgG会降低μ并增加凝胶弹性模量。力的产生随离子强度增加适度增加,在盐水中添加IgG时不变,在麦芽糖中添加IgG时下降。本研究表明,力的产生主要取决于血小板功能,而凝块模量取决于纤维蛋白结构和血小板功能。(摘要截短至250字)