新鲜冰冻血浆融化后不同放置时间凝血因子变化的研究

摘要

Objective To study the changes in coagulation factors stored for different lengths of time after fresh frozen plasma(FFP)thawing.Methods Thirty-two samples of thawed FFP were detected by an automated coagulation analyzer SYSMEX CA-1500 to observe the changes in coagulation function and coagulation factors stored for different lengths of time at 4℃.Results Activated partial thromboplastin time (APTT) was significantly prolonged 12 hours after thawing.However, no significant changes were observed in prothrombin time (PT), thrombin time (TT) or fibrinogen (FIB).Coagulation factors showed varying degrees of attenuation in 24 hours.FⅤ, FⅦ and FⅧ were attenuated significantly in 6 hours by 17.2%, 9.47% and 12.5%, respectively.FⅨ began to attenuate in 12 hours and reached, the lowest rate of 21.1%, while FⅧ had the highest attenuation rate (52.0%) and showed the lowest stability.Conclusion The activity of coagulation factors is decreased with time after FFP thawing ,so it should be transfused as soon as possible to ensure the curative effect and clinical application.%目的 探讨新鲜冰冻血浆(fresh frozen plasma, FFP)融化后不同放置时间凝血因子的变化情况.方法采用自动血凝分析仪,对32份融化后4℃保存不同时间的FFP样品进行检测,观察凝血酶原时间(PT)、部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)等凝血功能指标以及凝血因子Ⅴ、Ⅶ、Ⅷ、Ⅸ的变化情况.结果 于4℃保存12 h后,FFP的APTT开始显著延长,但PT、TT及FIB均在24 h内均无显著变化;对凝血因子的检测结果表明,除凝血因子Ⅸ在融化后12 h显著衰减外,Ⅴ、Ⅶ及Ⅷ在融化后6 h内即呈现不同程度的显著衰减,衰减率分别为17.2%、9.47%和12.5%,但在融化24 h后Ⅷ最不稳定,衰减率达52%,而Ⅸ的衰减率最低,为21.1%.结论 FFP融化后,凝血因子的活性随时间逐渐衰减,因此融化后应越早输入越好,以确保临床用血的疗效和目的.