RESUMO
<p><b>OBJECTIVE</b>To evaluate the performance of thromboelastography (TEG) to monitor in vivo blood coagulation status and the efficacy of antiplatelet aggregation drugs in the patients with coronary heart disease (CHD) after oral anticoagulation.</p><p><b>METHODS</b>Seventy one CHD patients were enrolled in CHD group and 380 healthy persons with normal TEG were enrolled in the control group. After admission, all CHD patients were administrated with routine anti-platelet aggregation drugs at a clinically recommended dose. Then, TEG was applied to monitor the basic blood coagulation indexes, such as R value, K value, α angle, MA value, CI value and a series of related indexes on platelet inhibition.</p><p><b>RESULTS</b>Above 80% of the basic blood coagulation indexes in TEG were within normal reference range in the CHD group. the R value, MA value, α angle and CI value in the CHD group were not significanly different, from that in the control group, but the K value significantly increased (P<0.05). Compared with the control group, relatively higher ratio of male was included in the CHD patients at much older age (P<0.05), 83.1% of the CHD patients achieved significant anti-platelet aggregation effect (platelet inhibition rate>50%). Other antiplatelet aggregation indexes, MA, MAck and MA suggested a 9.86%, 4.23% and 12.68% risk of thrombogenesis, respectively. Among all the related antiplatelet aggregation indexes, MAck showed the strongest correlation with age (correlation coefficient, 0.111), and ADP% most highly correlated with body mass (correlation coefficient, 0.160).</p><p><b>CONCLUSION</b>TEG results can provide valuable coagulation information for clinicians, thus certainly guiding in the treatment for CHD patients receiving anti-platelet therapy. Moreover, the application of TEG can also provide accurate information for further individualized treatment of CHD patients, which would funther inprove the safety of anti-thrombotic therapy.</p>
RESUMO
The study was aimed to evaluate the yield of the COBE Spectra blood cell separator with auto-peripheral blood stem cell program for collection of peripheral blood hematopoietic stem cells (PBHSC) from HLA-matched ABO-incompatible allogeneic PBHSC donor, and observe the safety and effect of allogeneic peripheral blood hematopoietic stem cell transplantation (allo-PBHSCT) without removal of erythrocytes and plasma. PBHSC from 28 allogeneic donors were collected by COBE Spectra blood cell separator with auto-peripheral blood hematopoiEtic stem cell (auto-PBHSCT) program. Control group included 15 HLA-matched patients who received allo-PBHSCT with ABO-compatible grafts. The amount of PBHSC was harvested and the parameter was modified according to the hematocrit and mononuclear cell (MNC) counts of donors. The nucleated cell count, proportion of MNC, number of CD34(+) cells were detected, and reconstitution status of hematopoietic function and time for change into donor's blood group were observed. The results showed that the nucleated cell count proportion of MNC and number of CD34(+) cells showed no significant difference between groups of ABO incompatible and compatible (p > 0.05). All their hematopoietic functions were reconstituted. Between the ABO incompatibility and the compatible groups, the time of neutrophil and platelet recovery was not significantly different (p > 0.05), In ABO blood major incompatible and the compatible groups, the recovery of erythropoiesis were significantly delayed (p < 0.01). The blood type of 18 patients in ABO incompatible group was turned into donor's blood type successfully at 35-139 days after transplantation. It is concluded that major ABO incompatibility did not affect the erythropoiesis reconstitution in HLA matched allo-HSCT. the major incompatibility may be a main reason of erythropoietic delay.