双嘧达莫对恶性淋巴瘤患者外周血PAC-1和CD62p表达水平的影响

本研究探讨双嘧达莫对恶性淋巴瘤患者外周血血小板活化标志物PAC-1和CD62p表达水平的影响。选择32例恶性淋巴瘤患者随机分为单纯化疗组（单纯组）和化疗＋双嘧达莫组（联合组）。联合组患者在化疗基础上应用双嘧达莫100mg／d。另择15例健康体检者作为对照组。应用流式细胞术（FCM）和磁珠法分别于化疗当天、第3、7和14天检测恶性淋巴瘤患者外周血血小板PAC-1、CD62p和纤维蛋白原（FIB）的表达水平。结果表明，恶性淋巴瘤患者外周血PAC-1、CD62p和FIB水平较健康对照组明显升高（p〈0．01和0．05），且PAC-1与FIB间呈正相关（r=0．549，P〈0．01）。单纯组患者化疗当天和第3天的PAC-1表达较化疗第14天明显升高（P〈0．05和0．01）；化疗第3天其CD62p水平与化疗当天、第7和14天比较均升高（P〈0．05和0．01）。联合组患者化疗第14天的PAC-1表达较化疗当天、第3天降低（P〈0．05和0．01）；且化疗第14天的CD62p表达较化疗第3天时降低（P〈0．05）。联合组患者在化疗第3、7和14天的PAC—1、CD62p与单纯组患者比较表达呈下降趋势，但FIB变化不明显。结论：恶性淋巴瘤患者常出现外周血小板活化及高纤维蛋白原血症，化疗周期中应用双嘧达莫能有效地抑制血小板活化。

Influence of Dipyridamole on Expression of PAC-1 and CD62p in Patients with Malignant Lymphoma

This study was purposed to explore the expressions of platelet-activated markers PAC-1 and CD62p in peripheral blood of malignant lymphoma patients and the influence of dipyridamole on their expression. 32 lymphoma patients were divided into simple chemotherapy group （simple group ） and chemotherapy plus dipyridamole group （combined group） randomly, and 15 healthy peoples were selected as control group. The dipyridamole of 100 mg/day was given to the patients in combined group. The expression levels of PAC-1 , CD62p and fibrinogen （Fib） were detected by flow cytometry and magnetic bead method on day 0, 3, 7 and 14 of chemotherapy respectively. The results showed that the levels of PAC-1, CD62p and Fib in lymphoma patients were significantly higher than those in control group （p 〈0.01, 0.05 ）, moreover there was positive correlation between levels of PAC-1 and Fib （ r = 0. 549, p 〈 0. 01）. PAC-1 expression on day 0 and 3 of chemotherapy in simple group was higher than that on day 14 （p 〈0.05, 0.01 ） and CD62p expression on day 3 of chemotherapy was higher than that on day 0, 7 and 14 （p 〈 0.05, 0.01 ）. PAC-1 expression in combined group on day 14 of chemotherapy was lower than than on day 0 and 3 （p 〈 0.05, 0.01 ）, and CD62p on day 14 was lower than that on day 3 of chemotherapy （p 〈 0.05 ） ; PAC-I and CD62p expressions in combined group on day 3, 7 and 14 of chemotherapy were decreased than those in simple group, but Fib level was not changed significantly. It is concluded that the patients with malignant lymphoma usually accompany with platelet activation and hyperfibrinogenmia in peripheral blood. Applying dipyridamole routine dosage in chemotherapy can efficiently restrain platelet activation.