TEG技术在血小板保存过程中功能评价的应用研究

本研究旨在通过血栓弹力图（thmmbelastography，TEG）技术探讨血小板保存过程中功能的变化。随机选择各项指标均符合国家标准的单供者机采血小板12个单位并在（22±2）℃条件下振荡保存。分别在保存1、2、3、4、5天检测血栓弹力图参数，包括反应时间（R）、凝血时间（K）、α角（ANG）和最大振幅（MA），同时检测血小板计数、平均血小板体积、低渗休克反应（HSR）水平、CD62p阳性率及凝血酶激活CD62p再表达率的变化，综合评价血小板保存过程中体外功能的变化情况。结果显示：平均血小板体积随保存时间延长而轻度增大，但无统计学差异（p〉0．05）；血小板膜表面CD62p表达率随保存时间延长而显著升高（P〈0．01）；凝血酶激活后CD62p再表达率随保存时间的延长而显著下降（p〈0．01）；血小板低渗休克反应水平在1-5天无明显变化（P〉0.05）；R值随保存时间延长而明显延长（P〈0．01），K值无明显变化（P〉0.05），α角虽呈轻度下降趋势，但无显著差异（P〉0．05）；MA值在保存1-4天无显著变化，保存5天时仅有轻度下降（P〈0．05）。结论：虽然血小板随保存时间延长激活率明显升高，但反映血小板综合凝血功能的最大振幅（MA值）和HSR水平在整个保存期内并无显著变化，说明保存期末的血小板仍然具有良好的止血功能；血栓弹力图参数MA值可以作为一项重要指标用于血小板保存过程中的功能评价。

Application of Thrombelastography in Evaluation of Platelet Function during Storage

This study was aimed to explore changes of platelet function in vitro during storage by thrombelastography (TEG). 12 units plateletpheresis were randomly selected and stored at 20 to 24 degrees C with agitation. Thrombelastography variable parameters R, K values and maximal amplitude (MA) were measured on 1, 2, 3, 4, 5 days of platelet storage. Platelet concentration, mean platelet volume (MPV), hypotonic shock response (HSR), CD62p expression and CD62p reexpression on platelet surface were detected at the same time. Changes of platelet function in virto were systematically evaluated by above-mentioned indexes. The results showed that MPV augmented slightly with prolongation of preserved time (p > 0.05), and CD62p expression on platelet surface increased remarkably (p < 0.01), while CD62p reexpression decreased gradually (p < 0.01). There were no significant differences in HSR level of platelets during storage (p > 0.05). R value increased with prolongation of preserved time (p < 0.01). There were no obvious changes on K value and alpha Angle during storage (p > 0.05). There were no obvious changes in MA from 1 to 4 days, and MA decreased slightly on day 5 (p < 0.05). It is concluded that there was no significant change in MA and HSR which reflects comprehensive coagulation of platelets during storage. Platelets on the end of storage have excellent function of hemostasis; Thrombelastography parameter MA value can be used as a valuable indicator for evaluation of platelet function in vitro during storage.