Boomgaard M N, Stulp J G, de Korte D, Pietersz R N, Reesink H W, Huijgens P C, Loos J A
Central Laboratory of the Netherlands Red Cross Blood Transfusion Service, Amsterdam.
Haemostasis. 1993 Nov-Dec;23(6):327-34. doi: 10.1159/000216896.
The effect of warming (37 degrees C) of stored platelet concentrates (PC) on the post-transfusion platelet function as measured by the adhesion capacity in a rectangular perfusion system under flow conditions was analyzed in 22 patients undergoing transfusion for stable thrombocytopenia. Nine patients received a PC stored at 22 degrees C and incubated at 37 degrees C for 1 h before transfusion, 10 patients received a non-warmed PC, 3 patients received both a pre-warmed and a non-warmed PC. In the PC the platelet adhesion capacity to collagen was higher in the pre-warmed PC than in the non-warmed PC (33 +/- 5.9% coverage vs. 22 +/- 4.7% coverage, respectively, in a selected group with the same platelet concentration). The adhesion capacity to collagen of the platelets in the patient's blood, measured 10 min after transfusion, had increased considerably in both patient groups and 4 h later the adhesion capacity in both patient groups was similar to that of the pre-warmed PC before transfusion. We conclude that though pre-warming of stored PC had a beneficial effect on the adhesion capacity to collagen of the platelets in the PC, the clinical significance is questionable because already 10 min after transfusion the adhesion capacity to collagen of stored non-warmed platelets had improved to the level of the pre-warmed platelets and 4 h after transfusion this improvement was still present.
在22例因稳定型血小板减少症接受输血的患者中,分析了将储存的血小板浓缩物(PC)加热至37摄氏度对输血后血小板功能的影响,该功能通过在流动条件下的矩形灌注系统中的黏附能力来衡量。9例患者接受在22摄氏度储存并在输血前于37摄氏度孵育1小时的PC,10例患者接受未加热的PC,3例患者既接受了预热的PC也接受了未加热的PC。在PC中,预热的PC中血小板对胶原蛋白的黏附能力高于未加热的PC(在血小板浓度相同的选定组中,覆盖率分别为33±5.9%和22±4.7%)。输血10分钟后测量的患者血液中血小板对胶原蛋白的黏附能力在两个患者组中均显著增加,4小时后两个患者组中的黏附能力与输血前预热的PC相似。我们得出结论,尽管储存的PC预热对PC中血小板对胶原蛋白的黏附能力有有益影响,但其临床意义值得怀疑,因为输血后仅10分钟,储存的未加热血小板对胶原蛋白的黏附能力就已提高到预热血小板的水平,且输血后4小时这种改善仍然存在。