血浆CD_(62P)、P_(10)、D-二聚体的变化与肺血栓栓塞关系的研究

Relationship between the metabolic CD_(62P)、P_(10)、D-dimer in plasma and pulmonary thromboembolism

目的探讨血浆CD62P、P10、D-二聚体的变化与肺血栓栓塞的关系。方法选择经螺旋CT扫描,电子束CT肺动脉造影(CTPA)及临床相关病史和检查确诊的肺血栓栓塞(PTE)患者42例为患病组,年龄、身高、体重相匹配的健康自愿者30名为对照组。用流式细胞仪检测血小板膜上P-选择素(CD62P)、血小板膜糖蛋白凝血酶敏感蛋白(P10)的变化;酶联免疫吸附试验(ELISA)法检测血浆D-二聚体的变化,并比较溶栓和抗凝治疗前及治疗1周时各项指标的变化。结果患病组CD62P、P10、血浆D-二聚体均显著高于对照组,两组比较差异有统计学意义(t=0.68,P<0.01);患病组经治疗1周后CD62P、P10、血浆D-二聚体均较治疗前明显降低,治疗前后比较差异有统计学意义(t=0.52,P<0.05)。患者血浆CD62P、P10、D-二聚体与血气(PaO2)呈负相关(r=-0.754)。结论PTE患者存在明显的血小板活化、高凝状态和低氧血症,应用溶栓、抗凝和抗血小板治疗对PTE患者有价值。

Objective To explore the relationship between the metabolic CD62P, P10, D-dimer in plasma and pulmonary thromboembolism. Methods Forty-two patients with PTE diagnosed by spiral computed tomographic pulmonary angiography （CTPA） were included as the trial group, while 30 persons in which PE were excluded served as the control group. CD62P and P10 expressed on platelets were measured by flow cytometry, and plasma D-dimer was measured by ELIA and the changes of these parameter s were compared 1 week later. Results In the patients with PE, the levels of CD62P, P10 and D-dimer were significantly higher than those in the control group （t=0. 68, P〈0. 01）. After therapy 1 week the levels of CD62P, P10 and D-dimer were significantly lower than those before therapy （t=0. 52, P〈0. 05）. CD62P, P10 and D-dimer were negatively correlated with PaO2 （r=-0. 754）. Conclusion Platelet activatong, hypercoagulation and low PaO2 in patients with PTE. It is valuable to treat PTE using platelet activation and coagulant controlling drug.