Ocena trombocitne funkcije z agregometrijo z uporabo dveh avtomatiziranih sistemov

Nesterova, Anna (avtor), Božič Mijovski, Mojca (mentor), Fink, Martina (komentor)

Ocenjevanje trombocitne funkcije predstavlja ključen del diagnostike hemostatskih motenj in spremljanja učinkovitosti protitrombocitne terapije. Klasična optična agregometrija, ki temelji na meritvi spremembe optične gostote plazme, bogate s trombociti, po dodatku agonistov trombocitne agregacije, že desetletja velja za zlati standard. Vendar se zaradi tehnične zahtevnosti, potrebe po svežih vzorcih in odvisnosti od operaterja vse pogosteje uveljavljajo avtomatizirani sistemi, ki omogočajo stopnjo standardizacije in ponovljivosti rezultatov. Namen raziskave je bil primerjati rezultate trombocitne agregacije, dobljene z dvema avtomatiziranima analizatorjema – koagulacijskim analizatorjem CS-2500 in agregometrom Thrombomate XRA v primerjavi s klasično metodo. Analiza je bila izvedena z uporabo petih agonistov: adenozin difosfata, epinefrina, kolagena, arahidonske kisline in ristocetina. Kot končni parameter smo uporabili maksimalno agregacijo trombocitov v odstotkih. Pri adenozin difosfatu in arahidonski kislini sta Thrombomate XRA in CS-2500 pokazala zmerno do dobro klinično skladnost s klasično metodo v razvrstitvi preiskovancev. Pri adenozin difosfatu avtomatizirani sistemi praviloma izkazujejo nekoliko višje vrednosti maksimalne agregacije trombocitov, medtem ko je bila pri arahidonski kislini analitična skladnost med metodami izrazitejša. Pri epinefrinu ugotovljene statistično značilne razlike niso imele jasnega kliničnega pomena in niso vplivale na interpretacijo agregacijskega odziva, zato analitične primerljivosti ni bilo mogoče zanesljivo oceniti. Primerjava med napravami pri kolagenu je bila omejena zaradi neprimerljivih koncentracij reagentov, pri ristocetinu, analiziranem izključno v kontrolni skupini, pa neposredna primerjava ni bila mogoča. Skupno rezultati kažejo, da je bila hipoteza o visoki skladnosti med metodami delno potrjena za adenozin difosfat in arahidonsko kislino, medtem ko za ostale agoniste zaradi metodoloških omejitev ni bilo mogoče podati zanesljive ocene primerljivosti. Zaključimo lahko, da avtomatizirani sistemi predstavljajo obetavno alternativo klasični optični agregometriji pri agonistih, kjer je bila skladnost potrjena. Za širšo klinično uporabo ter primerljivost pri ostalih agonistih pa bodo potrebne dodatne multicentrične validacije, usklajene koncentracije reagentov in dosleden nadzor kakovosti.

• Jezik: Slovenski jezik
• Ključne besede: trombocitna funkcija, optična agregometrija, standardizacija, avtomatizirani analizatorji, agregacija
• Vrsta gradiva: Magistrsko delo/naloga
• Organizacija: FFA - Fakulteta za farmacijo
• Leto izida: 2026
• PID: 20.500.12556/RUL-178015
• Datum objave v RUL: 16.01.2026

Sekundarni jezik

• Jezik: Angleški jezik
• Naslov: Evaluation of platelet function with aggregometry utilizing two automated systems

Izvleček

The assessment of platelet function is an essential component of haemostasis diagnostics and antiplatelet therapy monitoring. Classical optical aggregometry, based on measuring changes in optical density of platelet-rich plasma after the addition of platelet aggregation agonists, has long been regarded as the gold standard. However, due to technical complexity, the need for fresh samples, and operator dependence, automated systems offering higher standardization and reproducibility are increasingly implemented. The aim of this study was to compare platelet aggregation results obtained using two automated analyzers — the CS-2500 coagulation analyzer and the Thrombomate XRA aggregometer — with those obtained using the reference method of classical optical aggregometry. The analysis was performed using five agonists: adenosine diphosphate, epinephrine, collagen, arachidonic acid, and ristocetin. Maximal platelet aggregation (%) was used as the primary endpoint. For adenosine diphosphate and arachidonic acid, the Thrombomate XRA and the CS-2500 showed moderate to good clinical agreement with the classical method in subject classification. For adenosine diphosphate, maximal platelet aggregation tended to be slightly higher on automated systems, whereas analytical agreement for arachidonic acid was more pronounced. For epinephrine, statistically significant differences did not have clear clinical relevance and did not affect the interpretation of the aggregation response; therefore, analytical comparability could not be reliably assessed. Comparison between analyzers for collagen was limited due to non-equivalent reagent concentrations, while ristocetin, analysed exclusively in the control group, did not allow direct comparison. Overall, the results indicate that the hypothesis of high agreement between methods was partially confirmed for adenosine diphosphate and arachidonic acid, whereas reliable assessment of comparability for the remaining agonists was limited by methodological constraints. In conclusion, automated systems represent a promising alternative to classical optical aggregometry for agonists with demonstrated agreement. Broader clinical application and comparability across a wider range of agonists will require additional multicentre validation, harmonised reagent concentrations, and consistent quality control.

• Ključne besede: platelet function, optical aggregometry, standardization, automated analyzers, aggregation