胰岛素对正常人血小板膜糖蛋白Ⅱb／Ⅲa表达的影响及机制

目的 探讨胰岛素对正常人血小板膜糖蛋白(GP)Ⅱb／Ⅲa表达的影响及其机制。方法 建立全血血小板膜GPⅡb/Ⅲa表达的流式细胞术测定方法，观察胰岛素以及一氧化氮合酶抑制剂硝基左旋精氨酸甲酯(L-NAME)、鸟苷酸环化酶(GC)抑制剂亚甲蓝(MB)分别及与胰岛素联合作用下对血小板膜GPⅡb/Ⅲa表达的影响。结果 (1)胰岛素对正常人静息血小板膜GPⅡb／Ⅲa表达无明显影响；而显著抑制凝血酶、胶原活化的血小板膜GPⅡb／Ⅲa的上调表达，且该效应呈剂量和时间依赖性；(2)LNAME、MB几乎完全阻断胰岛素对血小板膜GPⅡb／Ⅲa表达的抑制效应。结论 胰岛素可通过NOS→NO→GC→GMP通路抑制血小板膜GPⅡb／Ⅲa的表达。

Effect of insulin on the expression of platelet membrane glycoprotein II b/III a and its mechanisms]

OBJECTIVE: To investigate the effects of insulin on the expression of platelet membrane glycoprotein (GP) IIb/III a and its mechanism in normal subjects. METHODS: Flow cytometry was used to detect the expression of the whole-blood platelet membrane GP b/ a. The respective effects of insulin, L-nitro-arginine methyl ester (L-NAME) and methylene blue (MB) and their combination on the expression of GP b/ a were also studied. RESULTS: Insulin had no effect on the expression of GP II b/III a in healthy subjects, but significantly inhibited the up-regulated expression of GP II b/III a induced respectively by thrombin and collagen. The inhibitory effects of insulin on thrombin- or collagen-induced expression of platelet membrane GP II b/III a were dose- and time-dependent, and could be completely blocked by L-NAME or methylene blue. CONCLUSION: Insulin may inhibit the over-expression of platelet membrane GP IIb/III a by NOS-->NO-->GC-->GMP pathway.