原发性血小板增多症血小板功能变化及与血栓的关系

目的 观察原发性血小板增多症(essential thrombocythaemia,ET)患者血小板功能的变化及对血栓形成的影响,探讨奥扎格雷钠在ET患者中防治血栓发生的作用.方法 采用流式细胞仪(FCM)测定患者CD62P、PAC-1的水平;采用ELISA方法测定血浆血栓素A2(TXA2)代谢产物TXB2和前列环素(PG12)代谢产物6-K-PGF1α水平;观察奥扎格雷钠干预治疗对ET患者血小板活性及血栓发生率的影响.结果 治疗前两组ET患者CD62P、PAC-1、TXB2、6-keto-PGF1α和TXA2/PGI2指标均明显高于正常组(P<0.01);奥扎格雷钠干预治疗后CD62P、PAC-1、TXB2、TXA2/PGI2均较治疗前明显降低(P<0.01),奥扎格雷钠干预治疗后CD62P、PAC-1和TXA2/PGI2与正常相比差异无统计学意义,而TXB2、6-keto-PGF1α仍高于正常,差异有统计学意义(P<0.05),常规治疗组治疗后与治疗前相比,各项指标均无明显变化.奥扎格雷钠干预治疗组后期血栓发生率为12.5%,常规治疗对照组血栓发生率为54.1%,差异有统计学意义(P<0.05).结论 ET患者存在血小板异常活化现象和一定的血栓形成危险,临床上除常规治疗减少血小板数量外,还应重视血小板功能的干预治疗,以改善血小板功能、防止血栓发生.

The study of relationship between platelet function and thrombus in patients with essential thrombocythaemia

Objective To observe the influence of the plasma thromboxane B2(TXB2) , 6-keto-PGFla, CD62P and PAC-1 and Thrombus in patients with primary thrombocytosis ( ET). To observe the effect of sodium ozagrel to prevent and treat thrombosis in patients with ET. Methods The subjects including 48 patients with ET. All patients were measured the plasma TXB2, 6-keto-PGF1α, CD62P and PAC-1 before and after treatment with or without sodium ozagrel. Results The plasma levels of CD62P, PAC-1, TXB2, 6-keto-PGF1α and TXA2/PGI2 in the patients with ET were significantly higher than the normal people ( P < 0.01 ) . The levels of CD62P, PAC-1, TXB2, TXB2/6-keto-PGF1α in patients with treatment of sodium ozagrel were higher than patients without treatment of sodium ozagrel ( P < 0. 01 ) . The plasma levels of CD62P, PAC-1 and TXA2/PG12 in patients with treatment of sodium ozagrel and that in normal people had no significant distinction ( P < 0. 01 ). All the index of conventional therapy group were higher than normal people(P<0. 01 ) but had no significant distinction with the patients before conventional treating. The incidence of thrombus in patients treated with sodium ozagrel was lower than patients treated without sodium ozagrel(P < 0.05). Conclusion With the treatment of sodium ozagrel in patients with ET, the CD62P, PAC-1, TXB2 and TXA2/PGI2 of plasma could be decreased. And the incidence of thrombus was decreased.