儿童特发性血小板减少性紫癜血小板功能研究

目的研究儿童特发性血小板减少性紫癜(ITP)血小板体内活化状态及体外活化功能,探讨血小板在ITP发病机制中的作用。方法流式细胞术(FCM)检测体内和体外5’-二磷酸腺苷(ADP)刺激后血小板表面活化分子GPIIb/IIIa和CD62P分子的表达,同时检测CD62P阳性血小板该分子的平均荧光强度(MCF)。结果ITP组与对照组体内活化血小板百分比有显著性差异(P=0.0001),ITP组显著低于对照组;两组CD62P分子的MCF无显著性差异。体外刺激血小板活化后,两组活化血小板百分比有显著性差异(P=0.0077),ITP组低于对照组;两组CD62P分子的MCF有显著性差异(P=0.0059),ITP组低于对照组。结论ITP患儿体内血小板处于低活化状态,提示其出血原因不仅是血小板数量减少,同时存在血小板功能减低,低活化的原因很可能是血小板自身功能障碍。

Study on platelet functions in childhood idiopathic thrombocytopenic purpura

Objective To explore the activation state of platelets in vivo and their ability to be activated in vitro after being stimulated for studying platelets function in the pathogenesis of childhood idiopathic thrombocytopenic purpura(ITP). Methods Measure the expression of GPIIb/IIIa and CD62P which are the markers of activated platelets in vivo by flow cytometry(FCM), and measure the mean channel fluroscence(MCF) of CD62P on CD62-positive platelets both in vivo and following platelets stimulated by ADP in vitro. Results The percentage of activated platelets in vivo in ITP group is statistically different from that in control group(P=0.0001), the former being distinctively lower than the latter. There is no statistical difference between the two groups in MCF of CD62P. After platelets were stimulated in vitro, the percentage of activated platelets is lower in ITP group than in control group(P=0.0077). MCF of CD62P is distinctively lower in ITP group than that in control group(P=0.0059).Conclusion In childhood ITP, the platelets in vivo is in lower activation, which may suggest that the reason of hemorrhage in ITP is not only the decrease of platelets count, but also the depression of platelets function. Lower activated platelets could be involved in the pathogenesis of childhood ITP.The reason of platelets lower activated may be platelets dysfunction.