脑梗死患者血小板活化状态及血小板参数的研究

目的:探讨脑梗死患者血小板膜糖蛋白P选择素(CD62P)、溶酶体蛋白(CD63)以及血小板3项参数即血小板计数(PLT)、血小板平均体积(MPV)和血小板最大聚集率(MAR)的变化及意义。方法:采用流式细胞术测定168例脑梗死患者血小板活化指标CD62P、CD63的表达,同时对其进行血小板3项参数PLT、MPV和MAR的测定,并与对照组比较。结果:(1)脑梗死患者急性期CD62P、CD63、MPV及MAR较健康对照组以及恢复期患者显著升高,而且恢复期患者上述指标仍高于健康对照组(均为P<0.01),而PLT在脑梗死急性期、恢复期及健康对照组之间均无显著性差异(均为P>0.05)。(2)CD62P、CD63、MPV及MAR与神经功能缺损程度评分呈显著直线正相关(r=0.84、0.817、0.684和0.698,均为P<0.01),而PLT与神经功能缺损程度评分间无相关性(r=0.32,P>0.05)。结论:脑梗死患者血小板大量活化及其体积和最大聚集率的升高参与了脑梗死的病理过程,MPV和MAR较PLT更能反映脑梗死的严重程度。

Study on platelet activation and platelet parameters in patients with cerebral infarction

Objective To investigate the changes and clinical significance of platelet membrane glucoprotein P-selection(CD_(62P)),lysosome membrance protein(CD_(63)) expression and three parameters of platelet in patients with cerebral infarction.Methods Peripheral blood platelet activation markers-CD_(62P),CD_(63) expression and three parameters-platelet count(PLT),mean platelet volume(MPV) and maximum platelet aggregation rate(MAR) were analyzed by flow cytometry and automatic blood analyzer in 168 patients with cerebral infarction and compared with 40 normal controls.Results(1) The positive rates of CD_(62P),CD_(63) and the levels of MPV,MAR in patients with cerebral infarction(both in acute phase and in convalescence) were significantly higher than those in normal controls(P <0.01),but there were no significant differences in PLT among these groups(P >0.05).The positive rate of CD_(62P),CD_(63) and the levels of MPV,MAR in acute phase were higher than those in convalescence after ischemic stroke(P <0.01).(2) There was a significant correlation among the levels of CD_(62P),CD_(63),MPV, MAR and the neurological functional deficit scale(r=0.84,r=0.817,r=0.684,r=0.698,P<(0.01)),but there was no relation between PLT and the neurological functional deficit scale(r=0.32,P>0.05).Conclusion Patients with cerebral infarction show evidence of enhanced platelet activation and increament of MPV and MAR,which may relate to the pathological process of cerebral infarction.Moreover MPV and MAR reflect the clinical severity of cerebral infarction better than PLT.