标本放置时间对PL-11检测血小板功能的影响

Effects of sample storage time on platelet function tested with PL-11 analyzer

  • 摘要: 目的 探讨标本在室温保存时,不同放置时间对血小板功能检测仪PL-11结果的影响。 方法 采集我院2012级学员队20位健康学员及2013年我院门诊20位服用氯吡格雷和阿司匹林的冠心病患者肘静脉枸橼酸钠抗凝全血,应用PL-11分别在采血后不同保存时间点(2 h、4 h、8 h)测定不同血小板活化诱导剂诱导的血小板聚集率。 结果 健康组:以花生四烯酸(arachidonic acid,AA)为血小板活化诱导剂时,2 h、4 h、8 h的放置时间对血小板聚集功能未产生影响(P> 0.05);二磷酸腺苷(adenosine di-phosphate,ADP)为诱导剂时,血小板聚集率在4 h明显降低(P< 0.01),8 h时已经降低至4.3%(P< 0.01);胶原(collagen,Col)诱导的血小板聚集率在采血后4 h时较2 h明显降低(P< 0.01),但与8 h差异无统计学意义(P> 0.05)。服用抗血小板药物组:AA诱导的血小板聚集率2 h、4 h、8 h两两差异均无统计学意义(P> 0.05),ADP诱导的血小板聚集率在4 h时明显降低(P< 0.01),4 h与8 h差异无统计学意义(P> 0.05),Col诱导的血小板聚集率在8 h后出现明显降低(P< 0.01)。 结论 枸橼酸盐抗凝血标本采集后放置时间对PL-11血小板功能检测存在影响,在检测健康人组或已服用双联抗血小板药物患者组时,AA诱导血小板聚集受时间影响较小,ADP与胶原诱导血小板聚集时随着标本放置时间延长,血小板聚集率降低。结合凝血功能检测对枸橼酸盐抗凝血的要求,PL-11检测血小板功能时,AA诱导聚集可在采血后4 h内完成,ADP与胶原诱导应在采血后2 h内完成。

     

    Abstract: Objective To identify the effects of storage time on platelet function tested with PL-11 analyzer under room temperature. Methods Citrated antecubital vein blood samples of graduate students in grade 2012 of Chinese PLA Medical School (n=20) and coronary heart disease (CHD) outpatients (n=20) treated with dual-antiplatelet drugs in the department of cardiology were drawn and tested by PL-11 analyzer at 3 testing points:2, 4 and 8 hours after blooding. The maximum platelet aggregation ratio was tested with 3 different activators:arachidonic acid (AA), adenosine di-phosphate (ADP) and collagen. Results Healthy young men:AA-induced platelet aggregation ratio showed no difference between 2 h, 4 h and 8 h (P> 0.05). When ADP used as the activator, platelet aggregation ratio reduced apparently at 4 h compared with 2 h (P< 0.01), and it reduced to 4.3% at 8 h (P< 0.01). There was a clear reduction of collagen-induced platelet aggregation at 4 h compared with 2 h (P< 0.01), while no difference was found between 4 h and 8 h (P> 0.05). Patients treated with dual-antiplatelet drugs:AA-induced results showed no statistic difference between 2 h, 4 h and 8 h (P> 0.05). ADP-induced results showed an obvious reduction at 4 h, while no difference was found between 4 h and 8 h (P> 0.05). Collagen-induced aggregation ratio reduced apparently at 8 h after blood sampling (P< 0.01). Conclusion Storage time affects the results of PL-11 platelet function test with limited influence on AA-induced platelet aggregation ratio, whatever in healthy men or patients treated with dual-antiplatelet drugs. ADP- or collagen-induced platelet aggregation ratio reduces as the time delay extending. The time delay between collection, transport and analysis should ideally be preferable in 4 hours when AA used as activator or 2 hours when ADP and collagen used as activators.

     

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