原发性血小板增多症患者血小板功能指标的变化及其与血小板数量关系的研究

目的1．观察原发性血小板增多症（primary thrombocytosis，PT）患者血小板功能指标CD62P、PAC-1、TXB2、6-keto-PGF1α及TXB2／6-keto—PGF1α比值的变化。2．观察PT患者血小板功能指标与血小板数量的相关性。3．探讨可能导致P，r患者血栓发生的机制。方法1．流式细胞仪（FCM）测定血小板表面的CD62P，PAC-1水平。2．ELISA方法测定血浆血栓素A2（TXA2）代谢产物TXB2和前列环素（PGI2）代谢产物6-keto—PGF1α水平。3．观察和比较各组血小板功能的变化及其与血小板数量变化的关系。结果1．阿患者血小板功能指标均高于正常组，P〈0．01。2．胛患者血小板功能指标变化与血小板数量相关性分析结果提示：PT患者各项血小板功能指标与血小板数目之间不存在相关性，P〉0．05。结论阴患者除血小板数量显著增多外，其血小板各项功能指标亦有明显异常。研究结果表明：PT患者发生血栓的危险因素除与其血小板数目异常增多有关外，还与血小板功能异常活化（血小板活化指标CD62P、PAC-1异常增高）及血浆TXB2、6-keto-PGF1α平衡失调（TXB2／6-keto—PGF1α比值异常增高）有关。而明患者血小板功能指标与其血小板数量之间不存在相关性，故治疗原发性血小板增多症除按常规治疗予以降低血小板数量外，还应同时注意对血小板功能的干预治疗。

The Changes and Associativity of Quantity and Function of Platelet in Patients with Primary Thrombocytosis

Objective 1. To observe the associativity of quantity and function of platelet in patients with PT. 2. To observe the necessary of functional treatment in patients with PT. Methods All patients were measured the plasma TXB 2, 6-keto-PGF1α, CD 62P and PAC-1 before and after treatment with sodium ozagrel or conventional drugs. Results 1. The levels of all the platelet functional index in the patients with PT were significantly higher than the normal people（P 〈0. 01 ）. 2. The plasma levels of platelet quantity in the patients with PT were significantly higher than the normal people（ P 〈0.01 ）. 3. The plasma levels of TXB 2, 6-keto-PGF1α, TXB2/6-keto-PGF1 α, CD 62P and PAC-1 and the platelet level had no dependability（P 〈 0.01 ）. Conclusion Functional treatment is necessary in patients with PT in order to prevent and treat the thrombus.