C-PG血小板聚集试验在单采血小板捐献者筛查中的应用

本研究探讨以阳离子没食子酸丙酯（C-PG）为激活剂的血小板聚集试验用于单采血小板捐献者筛查的可行性,并调查血小板献血者血小板功能缺陷的发生率.测定不同浓度C-PG诱导的健康献血者的血小板聚集率,以确定C-PG的最适应用浓度;检测30名志愿者服用阿司匹林前和服药24小时后的血小板聚集率,以确定血小板功能不良的筛查界点值;检测483例血小板捐献者的C-PG诱导的血小板聚集率,并对聚集功能不良者进行活化血浆凝固时间（APCT）测定.结果表明：血小板聚集率随C-PG浓度的增加而升高,当C-PG浓度达200μmol/L时,血小板聚集率达最高;服用阿司匹林24小时后的血小板聚集率与服药前相比,均表现明显减低（P＜0.001）,但以C-PG诱导180秒时的血小板聚集率减低最显著.血小板功能不良的筛查界点值确定为C-PG诱导180秒时的血小板聚集率小于20%;在483例血小板捐献者中,检出25例有血小板聚集功能不良,其中有11例表现为血小板促凝血活性减低.结论：C-PG诱导的血小板聚集试验能有效的检出血小板功能不良者,适用于血小板捐献者血小板功能的筛选;在血小板献血者中,血小板功能缺陷者的检出率大约为5%.

Application of Cationic Propyl Gallate as Inducer of Thrombocyte Aggregation for Evaluating the Platelet Function of Platelet Donors

The purpose of study was to investigate the feasibility of the application of cationic propyl gallate (C-PG) as inducer of platelet aggregation for evaluating the platelet function of single-donor plateletpheresis and identifying the incidence of defective platelet function among donors. Experiments were as follows: 3 healthy volunteers' platelet aggregation induced by 100-300 micromol/L C-PG was determined by LG-PABER analyzer to observe the effect of C-PG concentration on platelet aggregation; 30 healthy volunteers' platelet aggregation before and 24 hours after administration of 200-400 mg acetylsalicylic acid (ASA) was examined after induction by 200 micromol/L C-PG for determining the cut-off value to discriminate platelet dysfunction donors; the platelet aggregation of 483 platelet donors was detected and the activated plasma clotting time (APCT) of donors who have deficiency in platelet aggregation was examined for investigating the incidence of defective platelet function among donors. The results showed that platelets were activated by C-PG induction in a dose dependent manner, when concentration of C-PG reached 200 micromol/L, the percentage of platelet aggregation was highest. It significantly decreased after 24 hours with ASA than that before the administration (P < 0.001), especially in 180 seconds induced by C-PG. If cut-off point was fixed on the platelet aggregation < 20% in 180 seconds, donors of platelet dysfunction can be selected effectively. 25 of defective platelet aggregation function among 483 donors were detected, and 11 out of 25 platelet dysfunction donors had the deficiency in procoagulant activity with prolonged APCT. It is concluded that C-PG as inducer of platelet aggregation is feasible to screen the platelet function of donors. Five percent of platelet donors has function defect examined by C-PG as inducer of platelet aggregation.