Clot strength: A comparison between cord and adult blood by means of thrombelastometry
Clot strength: A comparison between cord and adult blood by means of thrombelastometry
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DOI：
10.1097/mph.0b013e318162bd2c
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发表时间：
2008-03-01
影响因子：
1.2
通讯作者：
Koestenberger, Martin
中科院分区：
文献类型：
--
作者：
Cvirn, Gerhard;Gallistl, Siegfried;Koestenberger, Martin
目的：评估脐带血与成人血液的凝块强度。方法：血栓弹力测定法 (TEM) 是首选方法，因为它提供了以最大凝块硬度 (MCF) 表示的凝块强度信息，以及以凝块形成时间和 a 角度表示的纤维蛋白聚合过程的信息。结果：与成人富血小板血浆相比，脐带的 MCF 显着降低（PRP，63.0 +/- 3.8 与 67.0 +/- 3.9 毫米，P = 0.006），脐带与成人全血相比（WB，55.3 +/- 3.8 与 59.3 +/- 3.6 毫米，P = 0.001），采用外源性激活剂血栓弹力测定法化验。我们认为，与成人血液和血浆样本相比，脐带血凝块强度降低可归因于新生儿纤维蛋白聚合受损：(i) 使用外源性激活剂和灭活血小板 (FIBTEM) 进行的血栓弹力测定法 (FIBTEM) 分析显示，与成人 PRP 相比，脐带中的 MCF 显着较低（23.0 +/- 3.1 mm 与 27.3 +/- 3.9 mm，P = 0.002），以及与成人 WB 相比，脐带中的 MCF 显着降低。 （11.6 +/- 2.3 毫米与 15.3 +/- 3.3 毫米，P < 0.001）； (ii) FIBTEM 测定中的 a 角在脐带中显着低于成人 WB（39.0 +/- 12.8 度与 55.5 +/- 12.3 度，P = 0.02）； (iii) 与成人 PRP 相比，FIBTEM 测定中的凝块形成时间明显更长（248.0 +/- 143.5 秒 vs. 81.5 +/- 39.8 秒，P = 0.001）。结论：在我们的实验条件下，新生儿纤维蛋白表现出聚合特性受损，导致与成人来源的纤维蛋白相比，凝块强度降低。
Objective: To evaluate the clot strength in cord versus adult blood. Method: Thrombelastometry (TEM) was the method of choice as it provides information on the clot strength in terms of the maximum clot firmness (MCF) and on the fibrin polymerization process in terms of the clot formation time and the a angle. Results: The MCFs were significantly lower in cord versus adult platelet rich plasma (PRP, 63.0 +/- 3.8 vs. 67.0 +/- 3.9mm, P = 0.006) and in cord versus adult whole blood (WB, 55.3 +/- 3.8 vs. 59.3 +/- 3.6 mm, P = 0.001) employing the thrombelastometry with extrinsic activator assay. We suggest that the diminished clot strength in cord versus adult blood and plasma samples is attributable to an impaired polymerization of neonatal fibrin: (i) the thrombelastometry with extrinsic activator and inactivated platelets (FIBTEM) assay revealed significantly lower MCFs in cord versus adult PRP (23.0 +/- 3.1 mm vs. 27.3 +/- 3.9 mm, P = 0.002) and in cord versus adult WB (11.6 +/- 2.3 mm vs. 15.3 +/- 3.3 mm, P < 0.001); (ii) the a angle in the FIBTEM assay was significantly lower in cord versus adult WB (39.0 +/- 12.8 degrees vs. 55.5 +/- 12.3 degrees, P = 0.02); (iii) the clot formation times in the FIBTEM assay were significantly longer in cord versus adult PRP (248.0 +/- 143.5 s vs. 81.5 +/- 39.8 s, P = 0.001). Conclusions: Neonatal fibrin shows impaired polymerization properties under our experimental conditions resulting in reduced clot strength compared with fibrin of adult origin.