血液透析对尿毒症患者血小板功能及膜糖蛋白的影响

Effect of hemodialysis on platelet function and membrane glycoproteins of uremic patients

观察血液透析对尿毒症患者血小板功能、血小板膜糖蛋白（ＧＰ）的影响并探讨其作用机理。方法应用血小板聚集仪和流式细胞仪观察尿毒症患者血液透析前后，血小板聚集功能和血小板膜糖蛋白的变化。结果血液透析前，尿毒症组的血小板聚集率明显低于正常对照组；其血小板膜糖蛋白Ⅰｂ、Ⅱｂ／Ⅲａ量与对照组相比无明显差异。血液透析后，患者血小板聚集率无明显增加，但其血小板膜ＧＰⅠｂ、ＧＰⅡｂ／Ⅲａ量明显增高。血液透析前后，以ＡＤＰ活化血小板，患者血小板表达的ＧＰⅡｂ／Ⅲａ量与对照组相比无显著性差异。结论血液透析不能改善尿毒症患者血小板功能。血液透析可使血小板活化，导致其膜糖蛋白升高。

Objective To observe the effect of hemodialysis on uremic platelet function and membrane glycoproteins (GP) and to investigate the mechanism of hemodialysis affecting platelet. Methods The change of uremic platelet aggregation function and platelet membrane glycoproteins was measured by platelet aggregation instrument and flow cytometry. Results Before hemodialysis, the platelet aggregation rate of uremic platelet was decreased markedly as compared with control. There was no significantly difference of the amount of platelet GPⅠb and GPⅡb/Ⅲa between patients and control. After hemodialysis, the uremic platelet aggregation rate was not increased while the amount of GPⅠb and GPⅡb/Ⅲa were increased significantly in contrast with control. Before and after hemodialysis. The amount of GⅡb/Ⅲa expressed on patients platelet, which platelet was activated by ADP, was not different from that of control. Conclusion Patients platelet function can not be improved by hemodialysis. The platelet can be activated by hemodialysis, which leads to the increasing of platelet GPs level.