吸入糖皮质激素对哮喘患者血小板活化作用的研究

目的探讨缓解期哮喘患者血小板活化状态及糖皮质激素的影响。方法采用流式细胞仪单抗检测方法，观察正常人及缓解期哮喘患者吸入二丙酸倍氯米松治疗６个月前后血小板膜糖蛋白（ＧＰ）的变化及与ＦＥＶ１变化的关系。结果缓解期哮喘患者治疗前ＧＰⅠｂ、ＧＰⅠｂ／ⅠＸ、ＧＰⅡｂ／Ⅲａ和ＧＭＰ－１４０较正常人升高（均为Ｐ＜００５）。吸入二丙酸倍氯米松治疗后，哮喘ＧＰⅠｂ、ＧＰⅡｂ／Ⅲａ、ＧＭＰ－１４０比治疗前降低（Ｐ＜００５），而且ＧＰⅡｂ／Ⅲａ、ＧＭＰ－１４０的变化均与ＦＥＶ１的变化呈正相关关系。结论缓解期哮喘患者存在血小板活化现象，吸入二丙酸倍氯米松可通过抑制血小板活化而减低气道阻力及气道慢性炎症；ＧＰⅡｂ／Ⅲａ、ＧＭＰ－１４０可作为判定吸入糖皮质激素疗效的指标之一。

Effect of corticosteroid aerosol on platelet activation in patients with asthma

ObjectiveTo implore the platelet activation in patients with asthma and the effect of beclomethasone dipropionate inhalation aerosol (BDP).Methods By using flow cytometry the mean mode of glycoprotein JP3GPbGPb/X GPb/agranule membrane protein-140(GMP-140) on platelets were measured in normal controls and asthmatic patients in remission before and after treatment with BDP. Meanwhile,the interrelation between GP and forced expiratory volume in one second to forced vital capacity ratio(FEV1) was studied.Results The GPbGPb/aGPb/X and GMP-140 in asthmatic patients in remission before treatment were significantly increased than those of normal subjects (P<005,respectively). GPb/aGPb/X and GMP-140 of asthmatic patients after therapy were significantly lower than those before therapy (P<005,respectively). Multivariate general linear regression analysis demonstrated that the change of GPb/a and GMP-140 before and after therapy were positively associated with the change of FEV1. Conclusion The platelet activation exists in asthmatic patients in remission. Corticosteroid aerosol could inhibited the platelet activation and airway resistance.GPb/a and GMP-140 may be one of the indicator of corticosteroid treatment.