老年慢性肺心病急性加重期血小板活化率与PH的关系

目的探讨老年慢性肺心病急性加重期患者血小板活化分子标记物膜糖蛋白PAC-1、GMP-140的变化及其与PH（肺动脉高压）的关系。方法用三色全血流式细胞术测定42例老年慢性肺心病急性加重期患者及42例缓解期患者外周血中血小板PAC-1、GMP-140的表达水平，并与30例老年健康对照者及30例非老年健康对照者比较。用超声心动图检测慢性肺心病患者肺动脉收缩压。结果老年慢性肺心病急性加重期组PAC-1、GMP-140的表达均明显高于缓解期组、老年健康对照组及非老年健康对照组（均P〈0．001），并与肺动脉收缩压呈正相关。老年缓解期组。PAC-1、GMP-140阳性表达率高于老年健康对照组（P〈0．05）及非老年健康对照组（均P〈0．001），老年健康对照组PAC-1、GMP-140阳性表达率亦高于非老年健康对照组（P〈0．05）。老年慢性肺心病急性加重期组患者PAC-1的变化与GMP-140之间有显著的正相关（r=0.77；P〈0．001）。结论老年慢性肺心病急性加重期患者血小板明显活化，其活化程度与PH关系密切。

Relationship between platelet activation and pulmonary hypertension in elderly patients with chronic cor pulmonary exacerbation

Objective To investigate the correlation of variations of PAC-1 ,GMP-140 of platelet activation marker and with PH （pulmonary hypertension） in elderly patients with chronic cor pulmonary exacerbation. Methods Subjects were divided into four groups （42 elderly patients with cor palmonary exacerbation,42 elderly patients with cor pulmonary remission stage,30 healthy elderly subjects and 30 healthy non-elderly subjects） . Positive rates of PAC-1 and GMP-140 were measured with tricolor flow cytometry. Results Compared with cor pulmonary remission stage group ,healthy elderly group and healthy non-elderly group,the expressions of both PAC-1 and GMP-140 increased significantly in patients with chronic cor pulmonary exacerbation （all P〈0.001 ）. The expresion of PAC-1 and GMP-140 in elderly patients with cot pulmonary remission stage were higher than in those of healthy elderly subjects （P〈0.05） and healthy non-elderly subjects （P〈0.001） . The expressions of PAC-1 and GMP-140 in healthy elderly subjects was statistically higher than that in healthy non-elderly subjects （P〈0.05）.There was a significant positive correlation between the molecular markers of platelet PAC-1 and GMP-140 in elderly patients with chronic cor pulmonary exacerbation （r =0.77 ;P〈0.001）, There was a positive correlation between PAC-1,GMP-140 and pulmonary arterial systolic pressure in elderly patients with chronic cor pulmonary exacerbation. Conclusion The platelet in elderly patients with chronic cot pulmonary exacerbation is obviously activated and its activation extent is closely correlated with PH.