慢性肺心病患者血小板功能的研究

目的研究慢性阻塞性肺疾病（ＣＯＰＤ）所致肺心病患者血小板功能的变化。方法将研究对象分为肺心病急性发作期组（７６例）、肺心病缓解期组（５４例）和正常对照组（２７名），采用玻璃球旋转法、比浊法、放射免疫分析法、流式细胞术等分别检测各组血小板粘附率（ＰＡｄＴ）、血小板聚集率（ＰＡｇＴ），血小板膜α－颗粒膜蛋白（ＧＭＰ１４０）和糖蛋白Ⅱ（ＧＰⅡ）水平。结果肺心病急性发作期组ＰＡｄＴ、ＰＡｇＴ、ＧＭＰ１４０和ＧＰⅡ分别为３１％±１６％、１４％±８％，１９０±４９分子数／血小板和１４５％±３６％。在缓解期组，上述各项检测值分别为３３％±１３％、３８％±１６％、１７８±３３分子数／血小板和１３７％±４８％，而正常对照组则分别为２２％±８％、２９％±１３％和１２１±３０分子数／血小板和９６％±３１％。提示，在肺心病急性发作期ＰＡｄＴ、ＧＭＰ１４０、ＧＰⅡ水平明显高于正常对照组，在缓解期，ＰＡｄＴ、ＰＡｇＴ、ＧＭＰ１４０等均升高。结论慢性肺心病患者体内血小板被激活，血小板粘附、聚集、释放等功能增强。认识并纠正上述病理变化可能有助于肺心病疗效的提高。

The study of platelet function in patients with chronic pulmonary heart disease

OBJECTIVE: To study the platelet function in patients with chronic pulmonary heart disease. METHOD: Subjects were divided into three groups (cor pulmonale exacerbation, cor pulmonale remission stage and normal control). Platelet adhesion rate (PAdT), platelet aggregation rate(PAgT), alpha-granule membrane protein (GMP-140) and glycoproteinII were measured by radioimmunoassay, flow cytometry and other methods. RESULT: In cor pulmonale exacerbation, the values of PAdT, PAgT, GMP-140 and GPII were31% +/- 16%, 14% +/- 8%, 190 +/- 49 molecule/platelet and 145% +/- 36% respectively. In cor pulmonale remission stage, the values were 33% +/- 13%, 38% +/- 16%, 178 +/- 33 molecule/platelet and 137% +/- 48% respectively. These findings showed that the values of PAdT, GMP-140 and GPII in cor pulmonale exacerbation were markedly increased, whereas PAgT was significantly reduced. However, PAdT, PAgT, GMP-140 and GPII in remission stage were all higher than that of normal group. CONCLUSION: In vivo platelet activation is indeed present in patients with chronic pulmonary heart disease.