Holme S, Moroff G, Murphy S
American Red Cross Blood Services, Mid-Atlantic Region, Norfolk, Virginia, USA.
Transfusion. 1998 Jan;38(1):31-40. doi: 10.1046/j.1537-2995.1998.38198141495.x.
There is no consensus regarding the use of specific in vitro tests for the assessment of the quality of platelet components. A literature review found that the platelet discoid shape as measured photometrically by the extent of shape change (ESC) and hypotonic shock response (HSR) correlated well with in vivo viability. The purpose of this study was to determine whether multiple research laboratories can perform the ESC and HSR assays in an accurate, reproducible manner, with acceptable sensitivity and comparable results.
Eleven laboratories conducted five identical experiments, each with a different unit of platelet-rich plasma (PRP). For each experiment, 2 half-units of PRP were prepared and stored overnight: 1 half-unit at 20 to 24 degrees C in CPD (CPD-PRP) and the other at 1 to 6 degrees C with 2 mg per mL of EDTA (cold EDTA-PRP) added to produce spherical platelets with reduced HSR. Platelet suspensions having different proportions of the two PRPs were prepared and evaluated in duplicate by ESC and HSR assays, and morphologically scored by microscopy. One-way ANOVA and Duncan multiple-range tests were performed to determine significant differences in assay results for suspensions having different proportions of CPD-PRP.
Comparable ESC (mean range: 20-28% for CPD-PRP and 1-6% for cold EDTA-PRP) and HSR (mean range: 58-81% for CPD-PRP and 12-31% for cold EDTA-PRP) measurements were obtained by nine laboratories. Duplicate testing showed high reproducibility of ESR and HSR results /in all laboratories. A 25-percent difference in the proportion of CPD-PRP (indicative of a difference of approximately 25% in the proportions of discoid and spherical platelets) was detected with a sample size of five (p<0.05) for both the ESC and HSR assays. A high correlation was found for the ESC assay and morphology score (r = 0.93, n = 345).
Multiple laboratories were able to obtain comparable results with the ESC and HSR tests. They were able to show that the tests can be performed in an accurate, reproducible manner and with acceptable sensitivity.
关于使用特定体外试验评估血小板成分质量尚无共识。一项文献综述发现，通过形状变化程度（ESC）和低渗休克反应（HSR）光度法测量的血小板盘状形态与体内活力密切相关。本研究的目的是确定多个研究实验室是否能够以准确、可重复的方式进行ESC和HSR检测，具有可接受的灵敏度和可比的结果。
11个实验室进行了5次相同的实验，每次实验使用不同单位的富血小板血浆（PRP）。对于每次实验，制备2个半单位的PRP并过夜储存：1个半单位在20至24摄氏度的CPD中（CPD-PRP），另一个在1至6摄氏度并添加2 mg/mL的EDTA（冷EDTA-PRP）以产生HSR降低的球形血小板。制备具有不同比例两种PRP的血小板悬浮液，并通过ESC和HSR检测进行一式两份评估，并通过显微镜进行形态学评分。进行单因素方差分析和邓肯多重范围检验，以确定具有不同比例CPD-PRP的悬浮液检测结果的显著差异。
9个实验室获得了可比的ESC（平均范围：CPD-PRP为20-28%，冷EDTA-PRP为1-6%）和HSR（平均范围：CPD-PRP为58-81%，冷EDTA-PRP为12-31%）测量值。重复检测显示所有实验室中ESR和HSR结果具有高重现性。对于ESC和HSR检测，样本量为5时检测到CPD-PRP比例有25%的差异（表明盘状和球形血小板比例差异约为25%）（p<0.05）。ESC检测与形态学评分之间发现高度相关性（r = 0.93，n = 345）。
多个实验室能够通过ESC和HSR检测获得可比结果。他们能够证明这些检测可以以准确、可重复的方式进行，并且具有可接受的灵敏度。
