Inhibitory effects of cisplatin and its conjugate with glutathione on blood platelet activity

Cisplatin ( cis -diamminedichloroplatinum II, CDDP) is a widely used chemotherapeutic agent; however, its haematological toxicity may become an important dose-limiting factor. The aim of the present study was to evaluate the effects of cisplatin and its metabolite with glutathione (GS-Pt conjugate) on thrombin- induced platelet aggregation, the secretory process and the arachidonate pathway in vitro . Pre-treatment of platelets with GS-Pt conjugate (60min, 20 mu M) but not with cisplatin alone, caused inhibition of thrombin-induced platelet aggregation. GS-Pt conjugate had also a strong inhibitory effect on the release of proteins and adenine nucleotides from platelet granules. After pre-incubation of platelets with cisplatin and its conjugate, we observed in thrombin-activated platelets, a decreased amount of malonyldialdehyde (a marker of thromboxane A synthesis). We suggest that arachidonate metabolism playsan important role in determining the cytotoxicity 2 of cisplatin.     

Physiologic and pathologic changes of platelets in pregnancy

Platelets are key players in haemostasis and thrombus formation. Defects affecting platelets during pregnancy can lead to heterogeneous complications, such as thrombosis, first trimester miscarriage and postpartum haemorrhage. The incidence of complications is increased in women who have heritable platelet function disorders. Modifications of platelet count or platelet functions during normal pregnancy and preeclampsia will be summarized and the management of pregnant women with heritable platelet function disorders will be discussed.     

免疫性血小板减少症125例临床分析

本研究旨在探讨免疫性血小板减少症(ITP)患者的临床特点。回顾性分析125例于2005年1月-2010年5月在我院住院治疗的ITP患者的临床资料、实验室检查结果及治疗效果。结果表明,125例患者发病中位年龄41岁,男女比为1∶1.78;治疗前平均血小板计数(28.59±23.05)×109/L;69.1%(67/97)的患者有风湿免疫检查异常;肝炎病毒和细小病毒B19携带率分别为37.3%(22/59)和44.8%(26/58);慢性患者CD3+T细胞为(62.7%±14.11%),在急性患者为(55.44%±14.31%)。慢性患者CD19+B细胞为(12.83%±6.96%),在急性患者为(19.47%±6.93%);91例患者行骨髓细胞膜抗体检查显示,54.9%(50/91)的患者抗体阴性,45.1%(41/91)患者抗体阳性;急性患者阳性率63.0%(17/27),在慢性患者为37.5%(24/64);激素联合环孢素治疗有效率为81.7%(49/60),部分难治性患者对RCP化疗或硫唑嘌呤细胞毒药物治疗的有效率分别为57.14%(4/7)和40.0%(2/5)。结论:ITP患者常合并病毒感染或风湿免疫学异常,急性患者以体液免疫功能亢进为主,慢性患者则表现为细胞免疫功能亢进;骨髓细胞膜抗体阳性的患者多是急性患者,因此在治疗方案的选择上应根据不同的发病机制选择不同作用机制的药物或药物组合,以取得更好的疗效。     

７７例发热伴血小板减少综合征病例流行病学特征分析

摘要：目的　分析７７例发热伴血小板减少综合征病例的临床与流行病学特征，为预防与治疗该病提供科学
依据。方法　采用流行病学描述性分析与个案调查的方法，回顾性收集、分析２０１０－２０１３年湖北省广水市
发热伴血小板减少综合征７７例病例的临床表现、实验室检查、病原学检查、流行病学特征等情况资料。结
果　７７例病例中１４例危重型患者死亡，其他６３ 例患者痊愈。病例多为居住在丘陵地区３５ 岁以上的中老
年人；发病呈明显季节性，集中在４～１０月；病例呈现高度散发，以丘陵地区多见；病原体以新布尼亚病
毒为主。本辖区尚未发现人感染人的依据。结论　发热伴血小板减少综合征病例是一种可防可治的疾病，
只要提高对本病的认识，做到早诊断、早治疗，就能有效降低该病死亡率。
关键词：发热伴血小板减少综合征；流行病学特征；临床特征
中图分类号：Ｒ１８４．６　　文献标识码：Ａ　　文章编号：１００９ ６６３９ （２０１４）０６ ０６０１ ０３     

Cerebral venous thrombosis due to essential thrombocythemia and worsened by heparin-induced thrombocytopenia and thrombosis

This case describes the medical history of a 61-year-old woman treated for cerebral venous thrombosis (CVT) leading to diagnosis of essential thrombocythemia (ET). During treatment with unfractionated heparin, after initial improvement of clinical state, signs of cerebral hypertension reappeared. Although the platelet count decreased, heparin-induced thrombocytopenia (HIT) was only suspected 2 days later when it dropped below the standard 150?×?10⁹?L^?1 threshold. HIT diagnosis was confirmed by the presence of anti-PF4/heparin IgG. This late finding was the cause of the extension of CVT with worsening of cerebral hypertension necessitating decompressive craniectomy. Elevated basal platelet count due to ET can delay diagnosis and treatment of HIT. In this case, physicians should be more attentive to platelet count variations rather than thrombocytopenia threshold.