Platelet reactivity in thromboelastometry. Revision of the FIBTEM test: a basic study
Platelet reactivity in thromboelastometry. Revision of the FIBTEM test: a basic study
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DOI：
10.1080/00365513.2017.1292538
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发表时间：
2017-01-01
影响因子：
2.1
通讯作者：
Ziaja, Krzysztof
中科院分区：
文献类型：
--
作者：
Biolik, Grzegorz;Kokot, Michal;Ziaja, Krzysztof
本研究旨在探讨对FIBTEM试验的改进，以更好地评估柠檬酸血中纤维蛋白原水平和纤维蛋白聚合质量，使用多板阻抗聚集法验证血小板抑制。根据标准研究方案（细胞松弛素D）和修改后的方案（合成IIbIIIa受体拮抗剂vs.乙酰水杨酸[ASA]+合成IIbIIIa受体拮抗剂代替细胞松弛素D），对26名健康志愿者的血液样本进行血栓弹性测定研究（EXTEM/FIBTEM试验）。独立于血栓弹性测定法，多板阻抗聚集法用于评估以下治疗阻断血小板的限制程度：(1)细胞松弛素D，(2)合成IIbIIIa拮抗剂或(3)ASA+合成IIbIIIa拮抗剂，以评估激动剂（ADP，胶原，凝血酶受体激活肽-6 [TRAP-6]和花生四烯酸）激活后的聚集反应。通过聚集分析，细胞松弛素D对血小板聚集的抑制作用比同时给药-IIbIIIa受体拮抗剂和ASA更弱。然而，在细胞松弛素D与合成的IIbIIIa受体拮抗剂同时施用后，观察到血小板聚集总量受到抑制。在血栓弹性测定中，通过添加合成的IIbIIIa受体拮抗剂单独或与ASA联合对其进行修饰后，EXTEM/ fitem测试中的A10、A20和MCF参数显着降低。总之，在这种基于多板和rotem的实验室方法中，通过聚集和血栓弹性测量观察到，双向阻断（iibiiia -拮抗剂+细胞chalasine D）足以完全抑制促凝血小板功能。
This study aimed to investigate modifications to the FIBTEM test to better assess fibrinogen levels and the quality of fibrin polymerization in citrated blood using Multiplate impedance aggregometry to verify platelet inhibition. Blood samples from 26 healthy volunteers were subjected to thromboelastometry studies (EXTEM/FIBTEM tests) in accordance with the standard study protocol (cytochalasin D) and according to a modified protocol (synthetic IIbIIIa receptor antagonist vs. acetylsalicylic acid [ASA]+synthetic IIbIIIa receptor antagonist instead of cytochalasin D). Independent of thromboelastometry, Multiplate impedance aggregometry was used to assess the degree of restriction by the platelet blocked with the following treatments: (1) cytochalasin D, (2) synthetic IIbIIIa antagonist or (3) ASA+synthetic IIbIIIa antagonist to assess the aggregation response to activation with an agonist (ADP, collagen, thrombin receptor activating peptide-6 [TRAP-6], and arachidonic acid). Via aggregometry, cytochalasin D more weakly inhibited platelet aggregation than simultaneous administration of the -IIbIIIa receptor antagonist with ASA. However, total platelet aggregation inhibition was observed after simultaneous administration of cytochalasin D combined with a synthetic IIbIIIa receptor antagonist. In the thromboelastometry, a significant decrease of the A10, A20 and MCF parameters were observed in the EXTEM/FIBTEM tests after they were modified by the addition of a synthetic IIbIIIa receptor antagonist alone or in combination with ASA. In conclusion, in this Multiplate- and ROTEM-based laboratory approach, a two-way blockade (IIbIIIa-antagonist+cytochalasine D) was sufficient to completely inhibit procoagulant platelet function as observed by aggregometry and thromboelastometry.