脑血管病患者血栓素B_2、血小板颗粒膜蛋白α-140和6酮前列腺素1α的测定及其意义

A comparison between TXB_2,GMP-140 and PAI in patients with cerebrovascular disease

目的探讨血浆中血栓素B2(TXB2),血小板颗粒膜蛋白α-140(GMP-140),6酮前列腺素1α(6- K-PGF1α),内皮素(ET)、组织型纤溶酶(tPA)、纤溶酶原激活剂抑制物(PAI)活性在脑动脉硬化、脑血栓发病过程的作用及临床意义。方法 TXB2、GMP-140、6-K-PGF1α、ET采用放射免疫法(RIA),tPA、PAI采用发色底物法分别测定脑动脉硬化,脑血栓和正常对照组的含量并进行分析。结果脑动脉硬化组,脑血栓组血小板指标TXB2,GMP-140水平明显高于正常组(均P<0．01),内皮细胞合成物6-K-PGF1α和ET含量脑血栓组分别明显低于和高于正常组(均P<0．01),脑动脉硬化组无明显差异(均P>0．05);纤溶指标tPA,tPA/PAI两组脑血管病血浆水平明量低于正常组;PAI水平虽有增高,但无明显差异(P>0．05)。结论脑血管病疾病存在血小板活化,内皮细胞受损、纤溶活力低下,这些改变可能参与疾病发病过程。

Objective To study the effects and clinical significance of plasma thromboxane B2 （TXB2）, platelet alpha granule membrance protein- 140 （ GMP- 140 ）, 6-Keto-PGF1 α （ 6-K-PGF1α ）, endothelins （ ET ）, tissue type plasminogen activator（tPA） and plaminogen activator inhibitor-1 （PAL1） in patients with cerebral arteriosclerisis and cerebral thrombosis. Methods Plasma TXB2,GMP-140,6-K-PGF1α and ET levels were determined by radioimmuno-assay. Plasma tPA and PAI were determined by the chromogenic peptide substrate method in controls and in patients with cerebral arteriosclerisis and cerebral thrombosis. Results The levels of plasma TXB2 and GMP- 140 were significantly higher in patients with cerebral arteriosclerisis and cerebral thrombosis than in the control group（P 〈 0.01 ）. The level of 6-K-PGF1α was lower and the level of ET was higher in patients with cerebral thrombosis than in the controls（P 〈 0.01 ）,while in the levels of 6-K-PGF1α and ET but no difference was found in patients with cerebral arteriosclerisis compared with controls（ P 〉 0.05）. The levels of tPA and tPA/PAI were significantly lower in patients with cerebral arteriosclerisis and cerebral thrombosis than in controls, Although the PAI level increased in patients with cerebral arteriosclerisis and cerebral thrombosis, no difference was found in statistics. Conclusions Activation of platelets,injury of endothelial cell and decreased activity of fibrinolysis in patients with cerebrovascular disease may be involved in the development of these diseases. Appropriate treatment should be adopted on the above abnormality.