慢性肺心病患者血流变学与血小板膜蛋白结构的改变(1)
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【摘要】 目的 探讨慢性肺心病的关系血流变学变化与血小板膜蛋白GPⅡb/Ⅲa、P-selectin(P-选择素)的变化。方法 测定46例慢性肺心病患者血流变学,用三色全血流式细胞术测定外周血中血小板GPⅡb/Ⅲa、P-selectin的表达水平,并与36例健康对照组比较。结果 慢性肺心组全血高切粘度、全血低切粘度、血浆粘度、纤维蛋白原均高于健康对照组(分别为P<0.05;P<0.05;P<0.001;P<0.001)。肺心病组GPⅡb/Ⅲa、P-selectin均明显高于健康对照组(均P<0.001)。肺心组GPⅡb/Ⅲa、P-selectin与血浆粘度和纤维蛋白原均呈正相关。结论 慢性肺心病患者血粘度增加、血小板明显活化,其血小板活化程度与血流变学变化关系密切。
【关键词】 慢性肺源性心脏病;血小板活化;血流变学;流式细胞术
Therelation between hemorrheology and platelet activation in patients with chronic cor pulmonary
TANJie,ZHANG Hong-yu,CHEN Hong-tao.
Departmen of Cardiology,the Fifth Affiliated Hospital of San Yat-sen University,Zhuhai 519000,China
【Abstract】 Objective To investigate the relationship among hemorrheology and platelet membrane glucoproteins (GPⅡb/Ⅲa and P-selectin) in patients with chronic cor pulmonary. Methods Subjects were divided into 2 groups (46 elderly patients with corpulmonary,36 cases of healthy subjects). Hemorrheology was determined,and positive rates ofGPⅡb/Ⅲa and P-selectin were measured with tricolor flow cytometry. Results Compared with healthy group,blood viscosity and the expressions of both GPⅡb/Ⅲa、P-selectin were increased significantly in patients with chronic cor pulmonary (all P<0.05). There was a positive correlation between the GPⅡb/Ⅲa、P-selectin and the blood viscosity and fibrinogenin patients with chronic cor pulmonale. Conclusion The platelet in patients with chronic cor pulmonary is at the overactivated state,the blood has the pathologio change of mucosity,thickness and there is a relation between activated platelet and hemorrheology.
【Key words】 Chronic cor pulmonary;Platelet activation;Hemorrheology;Flow cytometry
慢性肺源性心脏病患者由于长期慢性低氧,促红细胞生成素分泌增加,导致继发性红细胞生成增多,使血粘稠度增加,血流缓慢,导致肺血管阻力增高,加重肺心病肺动脉高压。有研究报道肺心病急性加重期尸检病例中肺细小动脉原位血栓发生率为 89.8% [1],这提示血小板在肺心病的发生、发展及其转归中可能起着重要作用,血小板活化时膜糖蛋白结构发生改变,其中糖蛋白GPⅡb/Ⅲa、P-selectin变化近年来越来越引起注目。本试验测定肺心病患者血流变学,用三色全血流式细胞术测定外周血中血小板GPⅡb/Ⅲa、P-selectin,探讨上述参数之间的相关性,以指导临床治疗。
1 资料与方法
1.1 一般资料 46例患者,男24例,女22例,平均年龄( 63.30±5.10)岁,为2006年10月至2009年10月本院患者,基础疾病为慢性支气管炎和阻塞性肺气肿,诊断符合1977年肺心病会议制订的标准[3]。所有入选患者无近期(2周内)服用抗血小板药物史。健康对照36例,男19例,女17例,平均年龄(62 ......
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