脑梗死患者活化血小板的检测及其临床意义

目的探讨脑梗死患者全血血小板膜糖蛋白Ⅱb/Ⅲa(PAC-1)、血小板颗粒膜糖蛋白140(CD62P)的变化及其临床意义。方法用全血流式细胞术测定76例脑梗死患者急性期和恢复期、30例高血压病患者和28例糖尿病患者外周血中血小板PAC-1、CD62P的表达水平,并与20例健康对照者比较。结果脑梗死组急性期、恢复期、高血压病组、糖尿病组PAC-1、CD62P的表达均明显高于正常对照组(均P<0.01)。脑梗死患者急性期PAC-1、CD62P的表达大梗死灶组>中梗死灶组>小梗死灶组,各组之间比较有显著性差异(P<0.01~0.05)。脑梗死患者急性期PAC-1、CD62P的表达重型>中型>轻型,各组之间比较有显著性差异(P<0.01~0.05)。结论脑梗死急性期、恢复期、高血压病患者、糖尿病患者均存在血小板活化;脑梗死病人血小板活化与病情及梗死灶大小有关,PAC-1、CD62P可作为判断病情的指标。

DETECTION OF ACTIVATED PLATELET AND ITS CLINICAL SIGNIFICANCE IN CEREBRAL INFARCTION

Objective To investigate the changes and clinical significance of platelet membrane glucoproteins(PAC-1 and CD_(62P))in patients with cerebral infarction.Methods Positive rates of PAC-1 and CD62P were measured with flow cytometry of blood samples from 76 patients with cerebral infarction,30 with hypertension and 28 with diabetes mellitus,and the reuslts were compared with those of 20 normal subjects.Results Compared with normal control group,both the expressions of PAC-1 and CD_(62P) increased significantly in patients with cerebral infarction,with hypertension and with diabetes mellitus(all P<0.01),the expressions of PAC-1 and CD_(62P) in the acute period of cerebral infarction being the highest(P<0.01).They were much higher in severe grade group than those in medium grade group and light grade group(P<0.01),and higher in medium grade group than those in light grade group(P<0.05).They were significantly higher in patients with big area infarction than those with middle area infarction and small area infarction(P<0.01),and they were significantly higher in patients with middle area infarction than those with small area infarction(P<0.05).Conclusions Activated platelets exist in patients with acute and convalescent cerebral infarction,in patients with hypertension and with diabetes mellitus.There is a relation between activated platelet and the degree of seriousness,size of infarction in patients with cerebral infarction.PAC-1 and CD_(62P) can be served as parameter to evaluate the state of cerebral infarction.