动脉硬化性缺血性脑卒中与血浆活化血小板的相关性研究

Correlation of atherosclerotic ischemic stroke and plasma activated platelets

目的了解动脉硬化性缺血性脑卒中(atherosclerotic ischemic stroke,AIS)与血浆活化血小板之间的关系。方法根据美国TOAST分型标准,对缺血性卒中患者进行临床分型。采用流式细胞术检测了40例大动脉粥样硬化型梗死(large artery atherosclerotic infarction,LAA)患者血浆中活化血小板的分子标志物CD62P、CD63、CD41的表达,并与30例无症状性颈部大动脉硬化(asymptomatic carotid stenosis,ACS)患者和30名正常对照者进行了比较。结果LAA患者血小板CD62P、CD63、CD41的表达显著高于对照组(P<0.001);血小板CD62P、CD63的表达在LAA组和ACS组之间无显著差异;然而,血小板CD41的表达LAA组显著高于ACS组(P<0.001);ACS组明显高于对照组(P<0.01)。结论血小板活化在动脉粥样硬化的发生发展中起关键作用,而血小板CD41表达的上调还可能是预测AIS发生的一个标志。

Objective To study the relation of atherosclerotic ischemic stroke（AIS） and plasma activated platelets.Methods All patients were classified into ischemic stroke subtypes based on TOAST criteria.Expressions of plasma platelet activation markers（CD62P、CD63、CD41） were detected by flow cytometry in 40 patients with large artery atherosclerotic infarction（LAA） and 30 patients with asymptomatic carotid stenosis（ACS） and 30 normal subjects as control.Results Expressions of CD62P、CD63 and CD41 on platelets were significantly higher in patients with LAA than those in controls（P〈0.001）.The extents of expressions of CD62P and CD63 had no significant differences between LAA and ACS patients.However,the expression of CD41 on platelets was significantly higher in patients with LAA than in those with ACS（P〈0.001）,and it was higher in patients with ACS than in control ones（P〈0.01）.Conclusion Platelet activation is a key step in the progression and development of atherosclerosis,the up-regulation of expression of CD41 on platelets may be a marker of platelet activation to provoke atherosclerotic ischemic stroke（AIS） from large artery atherosclerosis.