Platelet Contribution to Clot Strength in Thromboelastometry: Count, Function, or Both?
Platelet Contribution to Clot Strength in Thromboelastometry: Count, Function, or Both?
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DOI：
10.1080/09537104.2019.1581920
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发表时间：
2019-03-04
期刊：
影响因子：
3.3
通讯作者：
Baryshnikova, Ekaterina
中科院分区：
文献类型：
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作者：
Ranucci, Marco;Di Dedda, Umberto;Baryshnikova, Ekaterina
在血栓弹力测定法 (ROTEM (TM)) 中，EXTEM 和 FIBTEM 之间的幅度差异被认为是血小板对凝块强度 (PCSamp) 贡献的指数。弹性差 (PCSel) 很少使用。我们研究了 PCSamp 和 PCSel 反映 103 名接受心脏手术的患者的血小板计数和功能的能力，同时测量 ROTEM 和血小板功能测试（多电极聚集度 ADPtest 和 TRAPtest，Multiplate (TM)）。测试了 PCSamp 和 PCSel 与血小板计数和功能的关联。 PCSamp 显示与血小板计数和功能 (ADPtest) 的关联性较低（R 系数 0.32-0.39），而 PCSel 显示与相同变量的关联性较高（R 系数 0.55-0.71）。未发现 PCS 和 TRAPtest 之间存在关联。在多变量模型中，血小板计数（R 系数 0.60，P = 0.001）和 ADPtest（R 系数 0.36，P = 0.001）均与 PCSel 独立相关。 PCSel 预测低血小板计数/功能的辨别特性非常好（c 统计量 0.837）。在临床实践中，应以 EXTEM 和 FIBTEM 之间的弹性差异代替振幅差异。
In thromboelastometry (ROTEM (TM)) the difference in amplitude between the EXTEM and the FIBTEM is considered an index of platelet contribution to clot strength (PCSamp). The difference in elasticity (PCSel) is rarely used. We investigated the ability of PCSamp and PCSel in reflecting platelet count and function in 103 patients undergoing cardiac surgery, simultaneously measuring ROTEM and platelet function tests (multiple electrode aggregometry ADPtest and TRAPtest, Multiplate (TM)). PCSamp and PCSel were tested for association with platelet count and function. The PCSamp showed a low (R coefficient 0.32-0.39) association with platelet count and function (ADPtest), whereas the PCSel showed higher values of association (R coefficient 0.55-0.71) with the same variables. No association was found between PCS and TRAPtest. In a multivariable model, both the platelet count (R coefficient 0.60, P = 0.001) and the ADPtest (R coefficient 0.36, P = 0.001) were independently associated with the PCSel. The discrimination properties of the PCSel for the prediction of a low platelet count/function were very good (c-statistics 0.837). In clinical practice, the difference in elasticity between EXTEM and FIBTEM should replace the difference in amplitude.