血小板活化、高敏C反应蛋白与慢性肺心病患者肺动脉压的关系

The correlations between platelet activation marker,high-sensitivity C-reactive Protein and pulmonary arterial pressure in patients with chronic cor pulmonary

目的探讨慢性肺心病患者血小板活化指标PAC-1、CD62p和高敏C反应蛋白(hs-CRP)与肺动脉收缩压之间的关系。方法用三色全血流式细胞术测定50例慢性肺心病急性加重期患者及50例缓解期患者外周血中血小板PAC-1、CD62p的表达水平,采用免疫比浊法测定hs-CRP,并与40例健康对照者比较。用超声心动图检测慢性肺心病患者肺动脉收缩压。结果慢性肺心病急性加重期组PAC-1、CD62p的表达分别为(81.84±8.68)%、(47.12±6.30)%,明显高于缓解期组[(52.70±7.87)%、(33.66±5.83)%]及正常对照组[(48.73±5.55)%、(30.63±4.09)%](均P<0.01),并与hs-CRP、肺动脉收缩压呈正相关。慢性肺心病急性加重期组hs-CRP为(10.28±6.23)mg/L,明显高于缓解期组[(5.48±3.34)mg/L](P<0.01),并与肺动脉收缩压呈正相关。慢性肺心病急性加重期组肺动脉收缩压为(44.22±6.70)mmHg,明显高于缓解期组[(39.88±6.18)mmHg](P<0.01)。结论慢性肺心病急性加重期患者血小板明显活化,hs-CRP参与了慢性肺心病急性加重期炎症反应,血小板活化、炎症反应与肺动脉高压之间关系密切。

Objective To investigate the correlations between platelet activation marker（ PAC-1, CD62p） ,high-sensitivity C-reactive protein（hs-CRP） and the pulmonary arterial systolic pressure in patients with chronic cor pulmonary exacerbation. Methods Subjects were divided into three groups（50 patients with cor pulmonary in acute exacerbation,50 patients with cor pulmonary in remission and 40 normal controls）. Positive rates of PAC-1 and CD62p were measured with tricolor flow cytometry. This experiment also detected the pulmonary arterial systolic pressure in patients with chronic cot pulmonary through Doppler echocardiography. Hs-CRP levels were measured by nephelometry and turbidimetry in patients and normal controls. Results Compared with remission stage group and normal control group, the expressions of both PAC-1 and CD62p increased in patients with chronic cor pulmonary in acute exacerbation（ all P 〈0.01 ）. hs- CRP levels in patients with chronic cor pulmonary in acute exacerbation were significantly higher than those in patients in remission stage. There is a positive correlation between the PAC-1, CD62p in patients and pulmonary arterial systolic pressure and hs-CRP in patients with chronic cot pulmonary in exacerbation. Conclusions The platelet in patients with chronic cor pulmonary in acute exacerbation is at the overactivated state, hs-CRP was involved in the acute inflammation in acute exacerbation of eor pulmonary. there is a significant correlations between platelet activation, systemic inflammation and the pulmonary artery pressure in patients with chronic cor pulmonary in acute exacerbation.