Role of red blood cells in the anemia-associated bleeding under high shear conditions
Role of red blood cells in the anemia-associated bleeding under high shear conditions
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高剪切条件下红细胞在贫血相关出血中的作用
DOI：
10.1111/hae.13252
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
M. Shima and K. Nogami
中科院分区：
文献类型：
--
作者：
H. Yaoi;Y. Shida,;K. Ogiwara;K. Hosokawa;M. Shima and K. Nogami
背景红细胞（RBC）有助于血液流动下的止血，贫血可能有助于出血素质。目前用于评估止血的大多数实验室技术未考虑RBC的影响。测定，以确定红细胞在止血中的作用可能是有益的临床management.ObjectivesTo调查红细胞在hemostasis.MethodsHemostasis的影响进行了研究，使用一种新的微芯片流室系统（T-TAS ®）在贫血患者血管性血友病。随后，在总血栓分析系统（T-TAS）的红细胞的影响进行了检查，使用重组全血在各种hematocrit levels.ResultsIn体内：当患者贫血，并表现出持续出血症状，尽管保持足够的血管性血友病因子瑞斯托康辅助因子的活性水平，血栓形成由T-TAS确定延迟。然而，输注RBC可缓解出血症状，因此，T-TAS中的血栓形成得到改善。体外：T-TAS在1000 s-1时测定的血栓形成与红细胞压积呈剂量依赖性（在血细胞比容为0%、12.5%、25%和50%时，达到10 kPa的时间（T10）分别为10.0 ± 0，9.5 ± 1.4，6.7 ± 2.4，2.8 ± 1.6 min）。在2000 s-1时红细胞压积<25%时，血栓形成明显缺陷（T10>10 min）。结论红细胞在高切下止血中起重要作用，红细胞输注可有效治疗贫血患者的难治性出血。T-TAS测量似乎反映了血流下红细胞数量减少的止血结果，并可为监测患者提供有价值的方法。
BackgroundRed blood cells (RBCs) contribute to hemostasis under blood‐flow, and anemia might contribute to a hemorrhagic diathesis. The majority of current laboratory techniques to assess hemostasis do not consider the effects of RBCs. An assay to determine the role of RBCs in hemostasis could be beneficial for clinical management.ObjectivesTo investigate the influence of RBCs in hemostasis.MethodsHemostasis was investigated using a novel microchip flow‐chamber system (T‐TAS®) in an anemic patient with von Willebrand disease. Subsequently, the effects of RBCs in total thrombus analysis system (T‐TAS) were examined using reconstituted whole blood at various hematocrit levels.ResultsIn vivo: When the patient was anemic and demonstrated persisted hemorrhagic symptoms despite the maintained adequate von Willebrand factor ristocetin cofactor activity levels, thrombus formation determined by T‐TAS was delayed. However, transfusions of RBCs resolved bleeding symptom and, accordingly, the thrombus formation in T‐TAS improved.In vitro: Thrombus formation determined by T‐TAS at 1000 s−1was dose‐dependent on hematocrit (the time to reach 10 kPa (T10): 10.0 ± 0, 9.5 ± 1.4, 6.7 ± 2.4, 2.8 ± 1.6 min at hematocrits of 0%, 12.5%, 25% and 50%, respectively). Markedly defective thrombus formation (T10>10 min) was confirmed at a hematocrit <25% at 2000 s−1.ConclusionRed blood cells play an essential role in hemostasis under high shear, and RBC transfusions could be effective for refractory bleeding in patients with anemia. T‐TAS measurements appear to reflect the hemostatic consequences of diminished red cell numbers under blood‐flow, and could provide a valuable means for monitoring patients.