富血小板血浆量、采血量与抗凝剂比例对血小板聚集检验结果的影响

摘要

目的 探讨富血小板血浆量、采血量与抗凝剂比例对血小板聚集检验结果的影响.方法 采集72例健康志愿者静脉血标本,枸橼酸钠抗凝(1∶9),离心分离富含血小板血浆(PRP)和贫血小板血浆(PPP),2只血小板聚集杯分别加PRP 300 μl和500 μl,进行血小板聚集率检测;采集同量枸橼酸钠抗凝不同量静脉血(1∶10～1∶3)14例,离心分离富含血小板血浆(PRP)和贫血小板血浆(PPP),采用血浆比浊法,进行血小板聚集率检测.所得数据分别采用单因素配对t检验和方差分析进行统计分析.结果 花生四烯酸(AA)诱导,PRP 300 μl和500 μl的血小板聚集率分别为(57.0±33.6)%和(58.3±35.3)%,二磷酸腺苷(ADP)诱导,PRP 300 μl和500 μl的血小板聚集率分别为(62.3±18.7)%和(59.6±18.7)%,均P＞0.05;血浆Ca2+浓度在0.11～0.04 mmol/L时,AA和ADP诱导的血小板聚集率分别为(81.1±3.9)%～(26.4±27.01)%和(67.3±17.8)%～(8.6±11.1)%,血小板聚集率随Ca2+浓度的降低而降低,其中ADP诱导血小板聚集最明显,在Ca2+浓度0.08 mmol/L时聚集率明显下降.结论 富血小板血浆用300 μl测血小板聚集率对血小板聚集检验结果影响不明显;Ca2+浓度对血小板聚集检验结果有明显影响,血小板聚集率随Ca2+浓度的降低而降低,常规血小板聚集实验血浆Ca2+浓度应在0.09～0.11 mmol/L之间.%Objective To detect the effect of reacting dose of platelet-rich plasma(PRP) and extracellular calcium concentration on test results of platelets aggregation. Methods Blood samples of healthy volunteers were collected,then anticoagula-ted by sodium citrate(1 : 9,n=72),and PRP and platelet-poor plasma(PPP) were obtained by centrifuging the blood,then 300 μl and 500 μl of PRP were addedinto each of the reacting glasses;Different quantities of blood was anticoagulated by the same quantities sodium citrate(1 : 10' 1 : 3,n=14) and PRP and PPP were obtained by centrifuging the blood. Then the rate of platelet aggregation were detected following standard protocols by plasma turbidimetry and paired sample t test and One-Way ANOVA were adopted respectively to study and analyze statistically. Results The aggregation rate of 300 μl and 500 μl induced by AA and ADP were (57. 0 ± 33. 6)% and (58. 3 ± 35. 3)%,(62. 3 ± 18. 7)% and (59. 6 ± 18. 7)%,respectively ( P>0. 05). When plasma calcium concentration in the 0. 11～0. 04 mmol/L, the rate of platelets aggregation indued by arachidonic acid (AA) and adenosine diphosphate (ADP) were (81. 1 ± 3. 9)% ～ (26. 4± 27. 01)% and (67. 3 + 17. 8)% ～(8. 6 ± 11. 1)% respectively and gradually decreased with lower concentration of Ca2+ ,the rate indued by ADP decreases markedly at the concentration of 0. 08 mmol/L. Conclusion The effect of 300 μl of PRP on the test results of platelet aggregation was not significant. The effect of extracellular calcium concentration on the test results of platelet aggregation was significant,platelet aggregation rate decreases with the lower concentration of Ca2+. The extracellular calcium concentration for platelets aggregation should be in the range of 0. 09～0. 11 mmol/L.