Viscoelastic measurement of clot formation: a new test of platelet function.
Viscoelastic measurement of clot formation: a new test of platelet function.
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凝块形成的粘弹性测量：血小板功能的新测试。
DOI：
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发表时间：
1983
影响因子：
0.8
通讯作者：
E. Crawford
中科院分区：
文献类型：
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作者：
A. Saleem;C. Blifeld;S. A. Saleh;D. Yawn;M. Mace;M. Schwartz;E. Crawford
血小板功能的评估对临床领域的研究人员提出了挑战。描述了一种名为 Sonoclot 的仪器，用于测量血浆重新钙化时粘弹性特性（振动探针上的凝块阻抗）的变化。贫血小板血浆 (PPP) 和富血小板血浆 (PRP) 显示出独特且特征性的 Sonoclot 迹线。 PPP 的轨迹显示出滞后期和主波。这些参数对应于再钙化时间和纤维蛋白聚合。此外，PRP 的迹线还显示次级波和下行波。这些参数对应于血小板在凝块中的掺入和凝块的回缩。 PRP 参数受血小板数量和质量的影响。该仪器用于评估冠状动脉搭桥手术（CAB）后患者的血小板功能。在所研究的 69 名患者中，20 名患者没有出现过度出血。该组的血块阻抗描记正常。 24 名患者出血过多，血块阻抗正常，凝血测试表明手术出血的可能性。 22 名（92%）患者在尝试控制出血后证实了这一点。 25 名患者出血过多，凝血测试正常，血栓阻抗异常，表明血小板功能障碍。在 21 名（84%）患者中，输注浓缩血小板控制了出血，并相应校正了凝块阻抗。 Sonoclot 研究快速且易于执行，并且似乎是诊断 CAB 手术后止血问题的有价值且可靠的辅助手段。
Assessment of platelet function presents a challenge to the investigators in the clinical field. An instrument, Sonoclot, is described which measures changes in the viscoelastic properties (clot impedance on a vibrating probe) of plasma as it is recalcified. Platelet poor plasma (PPP) and platelet rich plasma (PRP) show distinct and characteristic Sonoclot tracings. Tracings of PPP show a lag period and a primary wave. These parameters correspond to recalcification time and fibrin polymerization. Tracings of PRP show, in addition, a secondary wave and a downward wave. These parameters correspond to the incorporation of platelets in the clot and retraction of the clot. The PRP parameters are influenced by the number and quality of the platelets. This instrument was utilized to assess the platelet function in patients after coronary artery bypass surgery (CAB). In 69 patients studied, 20 patients did not have excessive bleeding. The clot impedance tracings in this group were normal. Twenty-four patients had excessive bleeding, normal clot impedance, and coagulation tests indicating the possibility of surgical bleeding. This was confirmed in 22 (92 percent) patients upon exploration to control bleeding. Twenty-five patients had excessive bleeding, normal coagulation tests and abnormal clot impedance suggesting platelet dysfunction. In twenty-one (84 percent) of the patients, transfusion of platelet concentrate controlled the bleeding with corresponding correction of clot impedance. Sonoclot studies are quick and easy to perform, and appear to be a valuable and reliable adjunct in the diagnosis of hemostatic problems after CAB surgery.