血栓性心脑血管疾病与血小板微颗粒及其膜功能蛋白表达的关系

Relation of ischemic cardio-cerebro vascular diseases with platelet microparticle and expression of functional membrane protein

目的:运用以全血为标本的流式细胞仪(FCM)检测血小板微颗粒(PMP)方法,检测观察血栓性心脑血管疾病患者治疗前后PMP及其表面膜糖蛋白GPIIb/IIIa(PAC-1)及P-选择素(CD62P)的活化比率的变化;探讨PMP及PAC-1及CD62P活化比率检测在血栓性心脑血管疾病发病机制中的作用及其在病情预测和预后评价中的意义.方法:采用流式细胞仪分别对正常对照组、治疗前和治疗后血栓性心脑血管疾病组进行测定,分析各组PMP表达状况,CD62P,GPIIb/IIIa活化比率.结果:①正常对照组PMP:(65.5±9.8)/104P lt,CD62P:(3.2±0.8)%,PAC-1:(7.0±1.0)%;PMP:(64.3±8.3)/104P lt,PAC-1:(6.8±0.7)%,CD62P:(3.0±0.7)%,PMP:(64.3±8.2)/104P lt,PAC-1:(6.8±0.7)%,CD62P:(3.0±0.7)%;②血栓性心血管疾病组治疗前PMP:(209.2±21.9)/104P lt,CD62P:(54.7±7.8)%,PAC-1:(87.4±7.1)%;治疗后PMP:(117.9±11.9)/104P lt,CD62P:(25.2±6.3)%,PAC-1:(46.2±5.1)%;两者的PMP,CD62P,PAC-1水平均较正常对照组有显著性升高(P<0.01);治疗后较治疗前有显著性下降(P<0.01).③血栓性脑血管疾病组治疗前PMP:(217.3±36.6)/104P lt,CD62P:(52.8±9.3)%,PAC-1:(79.9±6.8)%;治疗后PMP:(134.2±12.9)/104P lt,CD62P:(24.3±6.1)%,PAC-1:(42.2±5.1)%;两者的PMP,CD62P,PAC-1水平均较正常对照组有显著性升高(P<0.01);治疗后较治疗前有显著性下降(P<0.01).结论:PMP及其表面膜糖蛋白PAC-1及CD62P表达的检测可作为血栓性心脑血管疾病疗效及预后判断的临床辅助诊断特异性指标之一,并为心脑血管疾病患者长期药物治疗提供理论依据.

AIM ： To detect platelet microparticle （ PMP ）, glycoprotein Ⅱb/Ⅲa （ PAC-1 ） and P-selection （CD62P） using whole blood flow cytometry （ WB-FCM ） in whole blood before and after the treatment in patients with ischemic cardiovascular and cerebrovascular diseases and the activation ratio of PAC-1 and CD62P, and to explore the role of PMPs, PAC-1 and CD62P in the pathogenesis of thrombotic cardiovascular and cerebrovascular diseases as well as the clinical significance of detecting PMP and activation ratio of PAC-1 and CD62P in whole blood in the prediction of illness state and in the prognostic evaluation. METHODS： The quantity of PMP and activation ratio of CD62P and GPⅡb/Ⅲa were measured before and after the treatment of patient group and control group using flow cytometry. RESULTS： ① Control group PMP： （65.5 ±9.8）/10^4pit, CD62P： （3.2 ± 0.8）%, PAC-1： （7.0±1.0）%; PMP：（64.3 ±8.3）/10^4pit, PAC-1：（6.8 ±0.7）%, CD62P： （3.0 ±0.7）%, PMP：（64.3 ±8. 2）/10^4Pit, PAC-1： （6. 8 ±0. 7）%, CD62P： （3. 0 ± 0.7） %;② Before treatment of patient group （with thrombotic cardiovascular disease） ： PMP： （209.2 ± 21.9）/10^4pit, CD62P： （ 54.7 ± 7.8 ） %, PAC-1 ： （ 87.4 ± 7. 1 ） % ; After treatment ： PMP： （ 117.9 ± 11.9）/10^4Pit, CD62P： （25.2 ± 6.3 ）%, PAC- 1 ： （46.2 ± 5.1 ） % ; They were significantly higher than those in control group（ P 〈 0.01 ）, and significantly lower after treatment of patient group than before treatment （ P 〈 0. 01 ）. ③ Before treatment of patient group （with thrombotic cerebrovascular disease） ： PMP：（217.3 ±36.6）/10^4pit, CD62P：（52.8 ±9.3）%, PAC-1：（79.9 ± 6. 8）%; After treatment： PMP： （134. 2 ± 12.9）/10^4pit, CD62P： （24. 3 ± 6. 1）%, PAC-1： （42. 2 ± 5.1 ）%; They were significantly higher than those in control group（ P 〈 0.01 ）, and significantly lower after treatment of patient group than before treatment（ P 〈0.01 ）. CONCLUSION： The levels of PMP, PAC-1 and CD62P can be taken as the specificity indices for the evaluation of therapeutic efficacy, prognostic judgement and clinical diagnosis. And it provides theoretical basis for the long-term medication therapies for cardio-cerebrovascular diseases.