Ho C H
Division of Hematology, Veterans General Hospital, Taipei, Taiwan, Republic of China.
Transfusion. 1998 Nov-Dec;38(11-12):1011-4. doi: 10.1046/j.1537-2995.1998.38111299056308.x.
The hemostatic effect of platelets has been well established, but the possible role of red cells in hemostasis has not yet been well studied. An evaluation of the hemostatic effect of packed red cell transfusion in patients with chronic anemia was the purpose of this study.
In a prospective study, bleeding time (BT), activated partial thromboplastin time (APTT), and prothrombin time (PT) were measured before and after the transfusion of allogeneic packed red cells in 42 patients with chronic anemia. The results were compared and analyzed.
APTT and BT decreased significantly after transfusion, by a mean of 1.3 seconds (p = 0.01) and 2.6 minutes (p < 0.01), respectively. PT did not change significantly after transfusion (p = 0.65). Factors studied (patient's age, sex, and renal function measurements; pretransfusion and posttransfusion hemoglobin levels, platelet counts, and PTs; change in platelet count [delta platelet count] and PT [delta PT] after transfusion) did not independently affect the change in BT (delta BT) or in APTT (delta APTT). The delta BT was not affected by the pretransfusion or posttransfusion levels of APTT or by the delta APTT. The delta APTT was not affected by the pretransfusion or posttransfusion levels of BT or by the delta BT. Diagnosis of malignant or benign diseases was found to affect delta APTT, but not delta BT. Patients with pretransfusion hemoglobin < or = 60 g per L had a 4.07 times greater chance of posttranfusion increase in BT than the patients with hemoglobin > 60 g per L (p = 0.04).
Red cell transfusion might decrease the APTT and BT in some anemic patients, though the actual cause of the decrease was not determined in the present study.
血小板的止血作用已得到充分证实，但红细胞在止血中的可能作用尚未得到充分研究。本研究旨在评估慢性贫血患者输注浓缩红细胞的止血效果。
在一项前瞻性研究中，对42例慢性贫血患者输注异体浓缩红细胞前后测量出血时间（BT）、活化部分凝血活酶时间（APTT）和凝血酶原时间（PT）。对结果进行比较和分析。
输血后APTT和BT显著降低，平均分别降低1.3秒（p = 0.01）和2.6分钟（p < 0.01）。输血后PT无显著变化（p = 0.65）。所研究的因素（患者年龄、性别和肾功能指标；输血前和输血后血红蛋白水平、血小板计数和PT；输血后血小板计数变化[血小板计数差值]和PT变化[PT差值]）均未独立影响BT变化（BT差值）或APTT变化（APTT差值）。BT差值不受输血前或输血后APTT水平或APTT差值的影响。APTT差值不受输血前或输血后BT水平或BT差值的影响。发现恶性或良性疾病的诊断影响APTT差值，但不影响BT差值。输血前血红蛋白≤60 g/L的患者输血后BT增加的几率是血红蛋白>60 g/L患者的4.07倍（p = 0.04）。
红细胞输血可能会降低一些贫血患者的APTT和BT，尽管本研究未确定降低的实际原因。
