建立健康成人血小板凝集試驗的生物參考區間

Establishment of Platelet Aggregation Test Reference Intervals in Healthy Adults

血小板凝集試驗是用來評估血小板的凝集功能用以診斷先天性血小板功能異常疾病。然而，因檢體收集不易及檢驗流程繁瑣等原因，國內尚未有實驗室建立血小板凝集試驗生物參考區間。為了針對台灣族群建立血小板凝集試驗正常參考區間，我們一共收集125位健康成人之富含血小板血漿（PRP）和缺血小板血漿（PPP）並利用BIO／DATA Aggregation Profiler血小板凝集分析儀進行分析。本研究中共使用四種血小板激活劑（agonist）分別為瑞斯托菌素（0.3－1.5 mg／mL）、二磷酸腺苷（2－20 μM）、膠原蛋白（1－5 μg／mL）與腎上腺素（1－100 μM）。分析結果利用SPSS軟體進行kolmogorov-smirnov test分析並以最終凝集率（％）表示。各項不同濃度激活劑（agonist）之生物參考區間建立如下:Ristocetin 1.5 mg／mL（84.43－97.23％）、Ristocetin 1.2 mg／mL（81.38－93.82％）、Ristocetin 1.0 mg／mL（56.58－93.54％）、Ristocetin 0.6 mg／mL（3.64－9.12％）、Ristocetin 0.3 mg／mL（4.32－8.96％）、ADP 20 μM（72.80－88.42％）、ADP 8 μM（62.93－86.95％）、ADP 6 μM（57.50－81.98％）、ADP 2 μ M（9.81－69.91％）、Collagen 5 μg／mL（78.98－92.10％）、Collagen 3.3 μg／mL（72.47－90.53％）、Collagen 2.0 μg／mL（59.46－86.74％）、Collagen 1.0 μg／mL（39.91－87.29％）、Epinephrine 100 μM（54.83－93.31％）、Epinephrine 10 μM（51.82－94.59％）及Epinephrine 1 μM（11.91－67.07％）。總結，本研究結果不僅能夠提供臨床醫師作為正確診斷的依據，亦可提供給其他實驗室做為參考的指標。

Platelet aggregation test can be used to evaluate the platelet aggregation function for the diagnosis of inherited platelet function abnormal diseases. However, the reference intervals of platelet aggregation test were not yet well established in Taiwan due to difficult sample collection and complicated examination procedure. To establish the reference intervals of platelet aggregation for Taiwanese population, platelet-rich plasma (PRP) and platelet-poor plasma (PPP) specimens were collected from 125 healthy adults and analyzed by BIO/DATA Aggregation Profiler aggregometer. In this study, four kinds of agonists were used, including Ristocetin (0.3-1.5 mg/mL), ADP (2-20 μM), Collagen (1-5 μg/mL), Epinephrine (1-100 μM). Results were statistical analyzed by kolmogorov-smirnov test using the SPSS software and were shown as final aggregation rate (%). The reference intervals of each agonists with different concentration were established as Ristocetin 1.5 mg/mL (84.43-97.23%), Ristocetin 1.2 mg/mL (81.38-93.82%), Ristocetin 1.0 mg/mL (56.58-93.54%), Ristocetin 0.6 mg/mL (3.64-9.12%), Ristocetin 0.3 mg/mL (4.32-8.96%), ADP 20 μM (72.80-88.42%), ADP 8 μM (62.93-86.95%), ADP 6 μM (57.50-81.98%), ADP 2 μM (9.81-69.91%), Collagen 5 μg/mL (78.98-92.10%), Collagen 3.3 μg/mL (72.47- 90.53%), Collagen 2.0 μg/mL (59.46-86.74%), Collagen 1.0 μg/mL (39.91-87.29%) and Epinephrine 100 μM (54.83-93.31%), Epinephrine 10 μM (51.82-94.59%) and Epinephrine 1 μM (11.91-67.07%), respectively. In conclusion, these results can not only be used for more accurate diagnosis but also be a reference for other laboratories.