流式细胞术分析活化血小板及其在急性肺血栓栓塞症中的临床意义

目的应用全血流式细胞术(FCM)结合血小板活化特异性单抗检测急性肺血栓栓塞症(PTE)患者血小板活化状态,探讨血小板活化在急性PTE中的作用及临床意义.方法以凝血因子I受体(FIB-R)、P-选择素(CD62P)作为分子标志物,利用FCM荧光标记法检测36例急性PTE患者和20例健康对照者微量全血FIB-R、CD62P血小板表面阳性表达的百分率,并比较急性PTE患者治疗前后FIB-R、CD62P在血小板表面阳性表达的变化.结果急性PTE患者血小板表面活性标志蛋白FIB-R、CD62P阳性率分别为(18.30±12.23)%、(12.07±6.54)%,均显著高于对照组[(1.81±0.88)%、(2.18±1.50)%,(P＜0.01)].溶栓和抗凝治疗后各项指标均较治疗前明显下降(均P＜0.01).结论急性PTE患者体内存在着明显的血小板活性增强,全血FCM能准确地反映体内血小板的活化水平.

Flow cytometric analysis of activated platelets and its clinical significance in pulmonary thromboembolism

Objective:To evaluate the status of platelet activation in vivo in patients with acute pulmonary thromboembolism(PTE). Method: Platelet activation markers including the fibrinogen receptor(FIB-R) and P-selectin(CD62P) were fluorescence labled with their monoclonal antibodies and analyzed by flow cytometry(FCM). FIB-R and CD62P were detected in 36 patients with acute PTE and 20 normal subjects, and the changes of these factors were compared 1 day, 7 day and 1 month later. Result:In PTE group, the levels of FIB-R and CD62P were significantly higher than those in control group (P<0.01). After therapy the levels of these factors were significantly lower than those before therapy (P<0.01). Conclusion: It is suggested that activation of platelet is enhanced in patients with acute PTE, which can be detected accurately by FCM analysis.