【摘要】 目的 研究不同离心条件、抗凝剂、全血细胞基数及血沉（ESR）、纤维蛋白原（FIB）对富血小板血浆（PRP）制备的影响。方法 首先选取180名患者在不同离心力和离心时间下进行两次离心，获得PRP制备的最佳离心条件；再选取20名患者，用EDTA-K₂管、枸橼酸钠管、血沉管抽血，采用第一次最佳离心条件离心后，比较不同抗凝剂下获得的上层血浆血小板回收率(E_（Pt）UL)、血小板富集系数(F_CP)、白细胞富集系数(F_WBC)、上层血浆回收率(E_（PI）UL)、下层红细胞压积(H_BL)的差异，并分析各指标与全血基础值、FIB和ESR的相关性。结果 不同离心力和离心时间下，E_（Pt）UL、F_CP、F_WBC、E_（PI）UL、H_BL差异均具有统计学意义（P<0.05）,第一步离心条件为100×g, 10 min或200×g, 5 min时，E_（Pt）UL均为99%,对应E_（PI）UL分别为75%、74%,F_CP分别为2.2、2.3,F_WBC分别为0.06、0.19,H_BL分别为0.75、0.73;第二步离心条件为783×g, 15 min时，获得的PRP的E_（Pt）UL及F_CP最佳；不同抗凝剂下基础血小板（PLT）、E_（Pt）UL、F_CP、F_WBC、H_BL差异均具有统计学意义（P<0.05）,EDTA-K₂组均高于枸橼酸钠组，E_（PI）UL两组间差异无统计学意义（P>0.05）;全血基础白细胞（WBC）和PLT与任何统计指标无相关性（P>0.05）;红细胞（RBC）与血红蛋白（HGB）、红细胞压积（Hct）之间有相关性（P<0.01）,相关系数分别为0.77、0.82;RBC、HGB、Hct均与F_CP、F_WBC有相关性（P<0.01）,其中RBC、HGB、Hct与F_CP的相关系数均为0.80,RBC、HGB、Hct与F_WBC的相关系数分别为0.62、0.51、0.58;ESR与FIB浓度呈正相关（P<0.01）,相关系数为0.73;ESR、FIB仅与F_CP呈正相关（P<0.05）,相关系数分别为0.49、0.46,与E_（Pt）UL、F_WBC、E_（PI）UL、H_BL无相关性。结论 第一步离心条件为100×g, 10 min或200×g, 5 min,第二步离心条件为783×g, 15 min时，获得的PRP最佳；在本研究评估的制备效率指标上，抗凝剂EDTA-K₂优于枸橼酸钠，RBC、HGB、Hct、ESR、FIB与F_CP存在显著正相关关联。更多还原

【Abstract】 Objective To investigate the effects of different centrifugation conditions, anticoagulants, baseline blood cell counts, Erythrocyte Sedimentation Rate（ESR）,and Fibrinogen（FIB） on the preparation of Platelet-rich plasma（PRP）.Methods First, 180 patients were selected to undergo double centrifugation at different centrifugal forces and durations to determine the optimal centrifugation conditions for PRP preparation.Then, another 20 patients were selected, and blood was drawn using EDTA-K₂ tubes, sodium citrate tubes, and erythrocyte sedimentation rate（ESR） tubes.After centrifugation under the first-step optimal conditions, the differences in the upper plasma platelet recovery rate(E_（Pt）UL),platelet enrichment coefficient(F_CP),leukocyte enrichment coefficient(F_WBC),upper plasma recovery rate(E_（PI）UL),and lower-layer hematocrit(H_BL) obtained with different anticoagulants were compared.Additionally, correlations between these parameters and baseline whole blood values, fibrinogen（FIB）,and ESR were analyzed.Results Under different centrifugal forces and centrifugation times, the differences in E_（Pt）UL,F_CP,F_WBC,E_（PI）UL,and H_BL were all statistically significant（P<0.05）.When the first step centrifugation conditions were 100×g, 10 min or 200×g, 5 min, E_（Pt）UL was 99%.The corresponding values for E_（PI）UL were 75% and 74% respectively, for F_CP were 2.2 and 2.3 respectively, for F_WBC were 0.06 and 0.19 respectively, and for H_BL were 0.75 and 0.73 respectively.When the second centrifugation condition was 783×g, 15 min, the E_（Pt）UL and F_CP of the obtained PRP were the best.The differences in basal platelet count（PLT）,E_（Pt）UL,F_CP,F_WBC,and H_BL under different anticoagulants were statistically significant（P<0.05）.The values in EDTA-K₂ group were higher than those in the sodium citrate group, while there was no statistically significant difference in E_（PI）UL between the two groups（P>0.05）.The basal white blood cell count（WBC） and PLT in whole blood were not correlated with any statistical indicators（P>0.05）.Red blood cells（RBC） were correlated with hemoglobin（HGB） and hematocrit（Hct）（P<0.01）,with correlation coefficients of 0.77 and 0.82 respectively.RBC,HGB,and Hct were all correlated with F_CP and F_WBC（P<0.01）.Among them, the correlation coefficients of RBC,HGB,and Hct with F_CP were all 0.80,and the correlation coefficients of RBC,HGB,and Hct with FWBC were 0.62,0.51,and 0.58 respectively.The ESR was positively correlated with the FIB concentration（P<0.01）,with a correlation coefficient of 0.73.ESR and FIB were only positively correlated with F_CP（P<0.05）,with correlation coefficients of 0.49 and 0.46 respectively, but had no correlation with E_（Pt）UL,F_WBC,E_（PI）UL and H_BL.Conclusion The best PRP was obtained when the first step’s centrifugation conditions were 100×g, 10min or 200×g, 5 min and the second step’s centrifugation conditions were 783×g, 15 min.In terms of the preparation efficiency indicators evaluated in this study, the anticoagulant EDTA-K₂ is superior to sodium citrate, and RBC,HGB,Hct, ESR,FIB are positively correlated with F_CP.更多还原