Evaluation of a whole blood remote platelet function test for the diagnosis of mild bleeding disorders.
Evaluation of a whole blood remote platelet function test for the diagnosis of mild bleeding disorders.
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DOI：
10.1111/jth.12555
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发表时间：
2014-05
期刊：
影响因子：
--
通讯作者：
UK GAPP Study Group
中科院分区：
文献类型：
--
作者：
Dovlatova N;Lordkipanidzé M;Lowe GC;Dawood B;May J;Heptinstall S;Watson SP;Fox SC;UK GAPP Study Group
轻度血小板功能障碍（PFDs）是一种复杂且难以诊断的疾病。目前的金标准测试，光透射聚集法（LTA），包括光聚集法，是时间和劳动密集型的，血液样本必须在静脉穿刺后的有限时间内处理。此外，许多疑似PFDs的受试者在LTA上并未显示血小板异常。评估易于使用的远程血小板功能试验（RPFT）作为疑似PFDs的诊断前试验的诊断潜力。在血小板基因分型和表型研究（GAPP, ISRCTN 77951167）招募的参与者中，将RPFT与荧光聚集法进行比较。对于RPFT，用血小板激动剂刺激全血，用PAMFix稳定，然后返回中心实验室，用流式细胞术分析p -选择素和CD63。在61名研究参与者（42例指数病例和19例亲属）中，亮度聚集和RPFT之间的一致性很好，84%的病例诊断一致（kappa=0.668, p<0.0001）。根据两项测试，29名参与者被确定为血小板功能不足，22名参与者表现正常。有4名参与者的荧光聚集检测发现了缺陷，但RPFT没有发现，有6名参与者的RPFT检测到血小板异常反应，而荧光聚集检测没有发现。这项研究表明，RPFT可能是一种易于使用的预测试，可以选择出血性疾病的参与者从广泛的血小板表型中受益。进一步开发和评估该测试是有必要的，在更广泛的出血过多的患者群体中，可以为pfd提供信息筛选测试。
Mild platelet function disorders (PFDs) are complex and difficult to diagnose. The current gold standard test, light transmission aggregometry (LTA), including lumi-aggregometry, is time- and labour-intensive and blood samples must be processed within a limited time after venepuncture. Furthermore, many subjects with suspected PFDs do not show a platelet abnormality on LTA. To assess the diagnostic potential of an easy-to-use remote platelet function test (RPFT) as a diagnostic pre-test for suspected PFDs. RPFT was compared to lumi-aggregometry in participants recruited to the Genotyping and Phenotyping of Platelets study (GAPP, ISRCTN 77951167). For RPFT, whole blood was stimulated with platelet agonists, stabilized with PAMFix and returned to the central laboratory for analysis of P-selectin and CD63 by flow cytometry. In the 61 study participants (42 index cases and 19 relatives) there was a good agreement between lumi-aggregometry and RPFT with diagnosis being concordant in 84% of cases (kappa=0.668, p<0.0001). According to both tests, 29 participants were identified to have a deficiency in platelet function and 22 participants appeared normal. There were 4 participants where lumi-aggregometry revealed a defect but RPFT did not, and 6 participants where RPFT detected an abnormal platelet response that was not identified by lumi-aggregometry. This study suggests that RPFT could be an easy-to-use pre-test to select, which participants with bleeding disorders would benefit from extensive platelet phenotyping. Further development and evaluation of the test are warranted in a wider population of patients with excessive bleeding and could provide informative screening tests for PFDs.
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影响因子：
10.4
作者：
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通讯作者：
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影响因子：
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作者：
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DOI：
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发表时间：
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影响因子：
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通讯作者：
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影响因子：
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