老年慢性肺心病急性加重期血小板膜糖蛋白与PaO_2和PaCO_2的关系

The correlations between platelet activation and PaO_2,PaCO_2 in elderly patients with chronic cor pulmonale in acute exacerbation

目的探讨老年慢性肺心病急性加重期患者血小板活化标记物膜糖蛋白GPⅡb/Ⅲa、CD62p的变化与PaO2、PaCO2的关系。方法用三色全血流式细胞术测定42例老年慢性肺心病急性加重期患者及42例缓解期患者外周血中血小板GPⅡb/Ⅲa、CD62p的表达水平,检测患者PaO2、PaCO2,并与30例老年健康对照者及30例非老年健康对照者比较。结果老年慢性肺心病急性加重期组GPⅡb/Ⅲa、CD62p的表达率分别为(84.17±9.21)%、(50.21±7.68)%,均明显高于缓解期组、老年健康对照组及非老年健康对照组(均P<0.001)。老年肺心病缓解期组GPⅡb/Ⅲa、CD62p阳性表达率分别为(55.40±7.43)%、(35.83±6.08)%,高于老年健康对照组(均P<0.05)及非老年健康对照组(均P<0.001),老年健康对照组GPⅡb/Ⅲa、CD62p阳性表达率分别为(50.80±6.37)%、(31.97±4.91)%,亦高于非老年健康对照组[(45.53±7.94)%、(27.87±4.82)%](均P<0.05)。老年慢性肺心病急性加重期组GPⅡb/Ⅲa、CD62p与PaO2呈负相关、与PaCO2呈正相关。结论老年慢性肺心病急性加重期患者血小板明显活化,其活化程度与PaO2、PaCO2关系密切。

Objective To investigate the correlations between platelet activation marker（ GP Ⅱ b/ Ⅲ a, CD62p） and PaO2, PaCO2 in elderly patients with chronic cot pulmonale in acute exacerbation. Methods Subjects were divided into four groups （42 elderly patients with cor pulmonale in acute exacerbation,42 elderly patients with cor pulmonale in remission,30 cases of healthy elderly controls and 30 cases of healthy non-elderly controls）. Positive rates of GP Ⅱ b/ Ⅲa and CD62p were measured with tricolor flow cytometry. This experiment also determined the arterial partial pressure of oxygen and the carbon dioxide partial pressure in patients with chronic cor pulmonale. Results Compared with remission group, healthy elderly group and healthy non-elderly group, the expressions of both GP Ⅱ b/Ⅲ a[ （84. 17 ± 9. 21 ）% ] and CD62p[ （50. 21 ± 7.68 ）% ] increased significantly in patients with chronic cor pulmonale in acute exacerbation （ all P 〈 0. 001 ）. The expressions of both GP Ⅱ b/Ⅲ a [ （ 55.40 ± 7.43 ） % ] and CD62p [ （ 35.83 ± 6.08 ） % ] in elderly patients with cor pulmonale in remission were statistically higher than those in healthy elderly controls （ P 〈 0.05 ） and healthy non-elderly controls （ P 〈 0. 001 ）. The expressions of both GP Ⅱ b/Ⅲ a [ （ 50. 80 ± 6. 37 ） % ] and CD62p [ （ 31.97 ± 4. 91 ） % ] in healthy elderly subjects were statistically higher than that in healthy non-elderly controls [ （ 45.53 ± 7. 94 ） % , （ 27.87 ± 4. 82 ） ] （ P 〈 0. 05 ）. There is a negative correlation between CD62p and PaO2 in elderly patients with chronic cor pulmonale in acute exacerbation, and there is a positive correlation between the GP Ⅱ b/Ⅲ a, CD62p and PaCO2. Conclusions The platelet in elderly patients with chronic cor pulmonale in acute exacerbation is at the overactivated state, and there is a significant correlations between activated platelet and PaO2 , PaCO2.