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首页> 外文期刊>Platelets >Clot lysis time in platelet-rich plasma: Method assessment, comparison with assays in platelet-free and platelet-poor plasmas, and response to tranexamic acid
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Clot lysis time in platelet-rich plasma: Method assessment, comparison with assays in platelet-free and platelet-poor plasmas, and response to tranexamic acid

机译：富血小板血浆中的凝块裂解时间：方法评估，与无血小板和贫血小板血浆中的测定法比较以及对氨甲环酸的反应

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Fibrinolysis dysfunctions cause bleeding or predisposition to thrombosis. Platelets contain several factors of the fibrinolytic system, which could up or down regulate this process. However, the temporal relationship and relative contributions of plasma and platelet components in clot lysis are mostly unknown. We developed a clot lysis time (CLT) assay in platelet-rich plasma (PRP-CLT, with and without stimulation) and compared it to a similar one in platelet-free plasma (PFP) and to another previously reported test in platelet-poor plasma (PPP). We also studied the differential effects of a single dose of tranexamic acid (TXA) on these tests in healthy subjects. PFP- and PPP-CLT were significantly shorter than PRP-CLT, and the three assays were highly correlated (p<0.0001). PFP- and PPP-, but more significantly PRP-CLT, were positively correlated with age and plasma PAI-1, von Willebrand factor, fibrinogen, LDL-cholesterol, and triglycerides (p<0.001). All these CLT assays had no significant correlations with platelet aggregation/secretion, platelet counts, and pro-coagulant tests to explore factor X activation by platelets, PRP clotting time, and thrombin generation in PRP. Among all the studied variables, PFP-CLT was independently associated with plasma PAI-1, LDL-cholesterol, and triglycerides and, additionally, stimulated PRP-CLT was also independently associated with plasma fibrinogen. A single 1g dose of TXA strikingly prolonged all three CLTs, but in contrast to the results without the drug, the lysis times were substantially shorter in non-stimulated or stimulated PRP than in PFP and PPP. This standardized PRP-CLT may become a useful tool to study the role of platelets in clot resistance and lysis. Our results suggest that initially, the platelets enmeshed in the clot slow down the fibrinolysis process. However, the increased clot resistance to lysis induced by TXA is overcome earlier in platelet-rich clots than in PFP or PPP clots. This is likely explained by the display of platelet pro-fibrinolytic effects. Focused research is needed to disclose the mechanisms for the relationship between CLT and plasma cholesterol and its potential pathophysiologic and clinical relevance.
机译：纤维蛋白溶解功能障碍会导致出血或易形成血栓。血小板含有纤溶系统的多种因素，这些因素可能会上调或下调这一过程。但是，血凝块溶解中血浆和血小板成分的时间关系和相对贡献大多未知。我们开发了在富含血小板的血浆（PRP-CLT，有或无刺激）中的凝块溶解时间（CLT）测定，并将其与无血小板血浆（PFP）中的血凝溶解时间相似，并与先前报道的贫血小板血浆中的另一项测试进行了比较等离子（PPP）。我们还研究了健康受试者中单剂量氨甲环酸（TXA）对这些测试的差异作用。 PFP-和PPP-CLT明显短于PRP-CLT，并且这三种测定法具有高度相关性（p <0.0001）。 PFP-和PPP-，但PRP-CLT与年龄和血浆PAI-1，von Willebrand因子，纤维蛋白原，LDL-胆固醇和甘油三酸酯呈正相关（p <0.001）。所有这些CLT分析与血小板聚集/分泌，血小板计数和促凝试验之间无显着相关性，以探究血小板活化X因子，PRP凝固时间和PRP中凝血酶的产生。在所有研究的变量中，PFP-CLT与血浆PAI-1，LDL-胆固醇和甘油三酸酯独立相关，此外，受激PRP-CLT也与血浆纤维蛋白原独立相关。单一剂量的TXA 1g显着延长了所有三个CLT，但与不使用该药物的结果相反，未刺激或刺激的PRP的裂解时间明显短于PFP和PPP。这种标准化的PRP-CLT可能会成为研究血小板在凝块抗性和裂解中作用的有用工具。我们的结果表明，最初凝结在凝块中的血小板会减慢纤维蛋白溶解过程。但是，富含血小板的血块比PFP或PPP血块更早地克服了TXA诱导的抗凝块增加的抵抗力。这可能通过显示血小板促纤溶作用来解释。需要进行重点研究，以揭示CLT与血浆胆固醇之间的关系及其潜在的病理生理和临床意义。

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