中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2010年
22期
1547-1550
,共4页
李祖兰%陈兴明%杨亮程%邓新立%傅淑宏%蔡力力%周玉%陈静%白洁%丛玉隆
李祖蘭%陳興明%楊亮程%鄧新立%傅淑宏%蔡力力%週玉%陳靜%白潔%叢玉隆
리조란%진흥명%양량정%산신립%부숙굉%채력력%주옥%진정%백길%총옥륭
钙%血小板聚集%凝血酶原时间%凝血酶时间%部分促凝血酶时间%血栓弹力描记术
鈣%血小闆聚集%凝血酶原時間%凝血酶時間%部分促凝血酶時間%血栓彈力描記術
개%혈소판취집%응혈매원시간%응혈매시간%부분촉응혈매시간%혈전탄력묘기술
Calcium%Platelet aggregation%Prothrombin time%Thrombin time%Partial thromboplastin time%Thromboelastography
目的 探讨血浆钙离子(Ca2+)浓度对凝血相关参数检验结果的影响.方法 收集门诊体检志愿者静脉血标本,添加不同剂量氯化钙,采用血浆比浊法、凝固法和全血复钙法分别进行血小板聚集率(n=42)、凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)等凝血指标(n=21)和血栓弹力图(n=30)检测.结果 血浆Ca2+浓度在0.1-33.7 mmol/L时,二磷酸腺苷(ADP)和花生四烯酸(AA)诱导的血小板聚集率分别为(51.8±9.6)%-(94.7±4.8)%和(64.4 4±12.2)%-(93.2±5.5)%,随Ca2+浓度的增高而增高;Ca2+浓度为39.0 mmol/L时,血小板聚集率明显降低[ADP和AA诱导的血小板聚集率分别为(9.1±5.3)%和(11.1±4.5)%,均P<0.01]. Ca2+浓度在0.1-33.7 mmol/L时,PT随Ca2+浓度的增高而增高;TT的变化呈"V"型,以Ca2+浓度为4.4mmol/L时最小;APTT随Ca2+浓度的增高而降低,当Ca2+浓度>0.5 mmol/L时,APTT测不出值.Ca2+浓度在0.4～27.3 mmol/L时,血栓弹力图反应时间和凝固时间的变化呈"V"型,在Ca2+浓度为2.1 mmol/L时最小或接近最小;a角和最大幅度变化呈"∧"型,均以Ca2+浓度为2.1 mmol/L时最大.结论 血浆Ca2+浓度对凝血相关参数检验结果有明显影响,高钙(≥39 mmol/L)抑制血小板聚集、凝血因子活性和血液凝固,2.1 mmol/L是以全血复钙法进行血栓弹力图检测的适宜Ca2+浓度.
目的 探討血漿鈣離子(Ca2+)濃度對凝血相關參數檢驗結果的影響.方法 收集門診體檢誌願者靜脈血標本,添加不同劑量氯化鈣,採用血漿比濁法、凝固法和全血複鈣法分彆進行血小闆聚集率(n=42)、凝血酶原時間(PT)、凝血酶時間(TT)、活化部分凝血活酶時間(APTT)等凝血指標(n=21)和血栓彈力圖(n=30)檢測.結果 血漿Ca2+濃度在0.1-33.7 mmol/L時,二燐痠腺苷(ADP)和花生四烯痠(AA)誘導的血小闆聚集率分彆為(51.8±9.6)%-(94.7±4.8)%和(64.4 4±12.2)%-(93.2±5.5)%,隨Ca2+濃度的增高而增高;Ca2+濃度為39.0 mmol/L時,血小闆聚集率明顯降低[ADP和AA誘導的血小闆聚集率分彆為(9.1±5.3)%和(11.1±4.5)%,均P<0.01]. Ca2+濃度在0.1-33.7 mmol/L時,PT隨Ca2+濃度的增高而增高;TT的變化呈"V"型,以Ca2+濃度為4.4mmol/L時最小;APTT隨Ca2+濃度的增高而降低,噹Ca2+濃度>0.5 mmol/L時,APTT測不齣值.Ca2+濃度在0.4～27.3 mmol/L時,血栓彈力圖反應時間和凝固時間的變化呈"V"型,在Ca2+濃度為2.1 mmol/L時最小或接近最小;a角和最大幅度變化呈"∧"型,均以Ca2+濃度為2.1 mmol/L時最大.結論 血漿Ca2+濃度對凝血相關參數檢驗結果有明顯影響,高鈣(≥39 mmol/L)抑製血小闆聚集、凝血因子活性和血液凝固,2.1 mmol/L是以全血複鈣法進行血栓彈力圖檢測的適宜Ca2+濃度.
목적 탐토혈장개리자(Ca2+)농도대응혈상관삼수검험결과적영향.방법 수집문진체검지원자정맥혈표본,첨가불동제량록화개,채용혈장비탁법、응고법화전혈복개법분별진행혈소판취집솔(n=42)、응혈매원시간(PT)、응혈매시간(TT)、활화부분응혈활매시간(APTT)등응혈지표(n=21)화혈전탄력도(n=30)검측.결과 혈장Ca2+농도재0.1-33.7 mmol/L시,이린산선감(ADP)화화생사희산(AA)유도적혈소판취집솔분별위(51.8±9.6)%-(94.7±4.8)%화(64.4 4±12.2)%-(93.2±5.5)%,수Ca2+농도적증고이증고;Ca2+농도위39.0 mmol/L시,혈소판취집솔명현강저[ADP화AA유도적혈소판취집솔분별위(9.1±5.3)%화(11.1±4.5)%,균P<0.01]. Ca2+농도재0.1-33.7 mmol/L시,PT수Ca2+농도적증고이증고;TT적변화정"V"형,이Ca2+농도위4.4mmol/L시최소;APTT수Ca2+농도적증고이강저,당Ca2+농도>0.5 mmol/L시,APTT측불출치.Ca2+농도재0.4～27.3 mmol/L시,혈전탄력도반응시간화응고시간적변화정"V"형,재Ca2+농도위2.1 mmol/L시최소혹접근최소;a각화최대폭도변화정"∧"형,균이Ca2+농도위2.1 mmol/L시최대.결론 혈장Ca2+농도대응혈상관삼수검험결과유명현영향,고개(≥39 mmol/L)억제혈소판취집、응혈인자활성화혈액응고,2.1 mmol/L시이전혈복개법진행혈전탄력도검측적괄의Ca2+농도.
Objective To detect the effect of extracellular Ca2+ concentrations on test results of coagulation-related parameters.Methods Blood samples of outpatient medical volunteers were collected and then different doses of calcium chloride added.The rate of platelet aggregation (n=42),prothrombin time (PT),thrombin time (TT) and activated partial thromboplastin time (APTT) (n=21) and parameters of thromboelastography (n=30) were detected according to the standard protocols by plasma turbidimetry,coagulation and recalcification respectively.Results When the plasma Ca2+ concentration was in the range of 0.1-33.7 mmol/L.the rate of platelet aggregation gradually increased with a increasing concentration of Ca2+.And the rates induced by adenosine diphosphate (ADP) and arachidonic acid (AA) were (51.8±9.6)%-(94.7±4.8)% and (64.4±12.2)%-(93.2±5.5)%respectively.When the Ca2+ concentration was 39.0 mmol/L,the rate decreased markedly [ADP(9.1±5.3)%,AA (11.1±4.5)%,both P<0.01].When the Ca2+ concentration was in the range of 0.1-33.7 mmol/L,the values of PT gradually increased with a increasing concentration of Ca2+.The values of TT changed in "V"-type and became minimum when the calcium concentration was 4.4 mmol/L The values of APTT decreased with higher calcium concentrations and could not be determined when the concentration increased above 0.5 mmol/L When the Ca2+ concentration was in the range of 0.4-27.3 mmol/L,the values of reaction time and coagulation time of thromboelastography changed in "V"-type and became nearly minimal at the Ca2+ concentration of about 2.1 mmol/L The values of a angle and maximum amplitude changed in"∧"-type and became maximal at the Ca2+ concentration of 2.1 mmol/L.Conclusions The effect of Ca2+ concentration on the testing results of coagulation-related parameters is significant.A high calcium (≥39mmol/L) can inhibit the platelet aggregation,coagulation factor activity and blood coagulation.The Ca2+ concentration of 2.1 mmol/L seems to be the optimal concentration for thromboelastography by recalcification method.
