目的：探讨血小板聚集初期形状改变与聚集的关系，并分析其影响因素。方法制备小鼠、大鼠富血小板血浆（ PRP）和人洗涤血小板，以生理盐水、贫血小板血浆（ PPP）或Tyrode液调整血小板计数来建立不同的血小板体系，二磷酸腺苷（ ADP）或胶原诱导聚集，光学法测定血小板形状变化指标（最大负值和达最大负值时间）以及最大聚集率。结果人的最大负值、达最大负值时间比小鼠增加（P均＜0．05），最大负值比大鼠增加（P＜0．01）；大鼠达最大负值时间比小鼠增加（P＜0．01）。生理盐水稀释人PRP比PPP稀释人PRP最大负值减小，达最大负值时间延长（P均＜0．05）。在人PRP中，胶原所致最大负值比ADP减小（P＜0．05），达最大负值时间增加（P＜0．01）；在人洗涤血小板中，胶原所致最大负值、达最大负值时间均比ADP增大（P均＜0．01）；ADP和胶原在洗涤血小板中比PRP中的最大负值、达最大负值时间（除应用胶原变大外）减小（P均＜0．01）。多元回归分析显示，聚集率与最大负值和达最大负值时间正相关（r分别为0．49、0．48，P均＜0．01）。结论血小板聚集初期变形促进聚集，人的比大鼠、小鼠增强，生理盐水稀释PRP和洗涤血小板减弱，在PRP中胶原比ADP所致变形减弱，在洗涤血小板中增强。%Objective To investigate the relationship between initial platelet shape change and aggregation and to ana -lyze the influential factors .Methods After the platelet rich plasma ( PRP) in mice and rats and human washed platelets were prepared, platelet count was adjusted with normal saline (NS), platelet poor plasma (PPP) or Tyrode′s buffer.Neg-ative peak ( NP) and time to reach negative peak ( TNP) and maximum aggregation induced by adenosine monophosphate ( ADP) or collagen were determined by the turbidimetric method .Results Human NP and TNP were more than that of mice (all P<0.05), only human NP was more than that of rats (P<0.01), whereas rat TNP was more than that of mice (P<0.01).Human TP decreased and TNP prolonged significantly (all P<0.05) in PRP diluted with NS as compared with that diluted with PPP.Compared with ADP, collagen decreased NP (P<0.05) and increased TNP (P<0.01) in human PRP, and increased NP and TNP (P<0.01) in human washed platelets.Both ADP and collagen decreased NP and TNP in washed platelets than in PRP with the exception of increase in NP induced by collagen (all P<0.01).Multivariate regression analysis showed that aggregation was positively correlated with NP (r=0.49, P<0.01) and TNP (r=0.48, P<0.01).Conclusions Initial platelet shape change enhances aggregation .It is more in human than in rats and mice, is less in PRP diluted with NS and washed platelets , decreases in PRP with collagen and increases in washed platelets with ADP.
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