血小板聚集初期形状变化与聚集的关系及其影响因素分析

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。

Relationship between initial platelet shape change and aggregation and analysis of influential factors

Objective To investigate the relationship between initial platelet shape change and aggregation and to analyze 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. Negative 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.