尿毒症患者血小板膜糖蛋白Ib含量和血浆vWF浓度变化及意义

THE SIGNIFICANCE AND CHANGE OFPLATELET MEMBRANE GLYCOPROTEIN IB ANDPLASMA VWF CONCENTRATIONS IN UREMIC PA-TIENTS

对尿毒症患者血小板膜糖蛋白（ＧＰ）Ｉｂ含量用两种不同方法进行测定，同时测定血浆中ｖｏｎＷｉｌｌｅ－ｂｒａｎｄＦａｃｔｏｒ（ｖＷＦ）浓度。结果显示尿毒症组血小板膜ＧＰＩｂ含量显著低于对照组（Ｐ＜０．０１），血透后减少更明显（Ｐ＜０．０５），两种方法测定的血小板膜ＧＰＩｂ减少之间呈正相关（ｒ＝０．５２Ｐ＜０．０１），尿素氮升高与血小板膜ＧＰＩｂ减少无明显相关关系（ｒ＝一０．２Ｐ＞０．０５），血浆中ｖＷＦ也显著高于对照组（Ｐ＜０．０１），提示：尿毒症患者血小板功能缺陷与血小板膜ＧＰＩｂ缺乏关系密切，尿毒氮升高可能不是直接使ＧＰＩｂ减少的原因，血小板止血功能障碍使ｖＷＦ代偿性增高，血液中存在抑制ｖＷＦ与血小板结合的物质。

e studied the platelet GPIb with two methods,vWF were determined in uremic patients.Our resultsshowed the platelet GPIb were decreased in uremia(P<0. 01).Post-dialysis GPIb levels were lower thanpre-dialysis. There was significant positive correlationbetween the platelet GPlb levels used two methods(r= 0. 52,P<0. ol).There was negative correlative be-tween the increment of urea nitrogen and reduction ofplatelet GPIb.The platelet dysfunction was closely re-lated to decrement of platelet GPIb in uremic patients.Platelet hemostatic dysfuntion raise plasma levels ofvWF compensatively.There were toxic metabolicproducts inhibited vWF binding to platelet in blood.