流式细胞术分析活化血小板及其在急性肺血栓栓塞症中的临床意义

Flow cytometric analysis of activated platelets and its clinical significance in pulmonary thromboembolism

目的:应用全血流式细胞术(FCM)结合血小板活化特异性单抗检测急性肺血栓栓塞症(PTE)患者血小板活化状态,探讨血小板活化在急性PTE中的作用及临床意义。方法:以凝血因子Ⅰ受体(FIB-R)、P-选择素(CD62P)作为分子标志物,利用FCM荧光标记法检测36例急性PTE患者和20例健康对照者微量全血FIB-R、CD62P血小板表面阳性表达的百分率,并比较急性PTE患者治疗前后FIB-R、CD62P在血小板表面阳性表达的变化。结果:急性PTE患者血小板表面活性标志蛋白FIB-R、CD62P阳性率分别为(18.30±12.23)%、(12.07±6.54)%,均显著高于对照组[(1.81±0.88)%、(2.18±1.50)%,(P<0.01)]。溶栓和抗凝治疗后各项指标均较治疗前明显下降(均P<0.01)。结论:急性PTE患者体内存在着明显的血小板活性增强,全血FCM能准确地反映体内血小板的活化水平。

Objective： To evaluate the status of platelet activation in vivo in patients with acute pulmonary thromboembolism（PTE）. Method： Platelet activation markers including the fibrinogen receptor（FIB-R） and P-selectin（CD62P） were fluorescence labled with their monoclonal antibodies and analyzed by flow cytometry（FCM）. FIB-R and CD62P were detected in 36 patients with acute PTE and 20 normal subjects, and the changes of these factors were compared 1 day, 7 day and 1 month later. Result： In PTE group, the levels of FIB-R and CD62P were significantly higher than those in control group （P〈0.01）. After therapy the levels of these factors were significantly lower than those before therapy （P〈0.01）. Conclusion： It is suggested that activation of platelet is enhanced in patients with acute PTE, which can be detected accurately by FCM analysis.