慢性肺心病患者血小板功能的研究

The study of platelet function in patients with chronic pulmonary heart disease

目的研究慢性阻塞性肺疾病（ＣＯＰＤ）所致肺心病患者血小板功能的变化。方法将研究对象分为肺心病急性发作期组（７６例）、肺心病缓解期组（５４例）和正常对照组（２７名），采用玻璃球旋转法、比浊法、放射免疫分析法、流式细胞术等分别检测各组血小板粘附率（ＰＡｄＴ）、血小板聚集率（ＰＡｇＴ），血小板膜α－颗粒膜蛋白（ＧＭＰ１４０）和糖蛋白Ⅱ（ＧＰⅡ）水平。结果肺心病急性发作期组ＰＡｄＴ、ＰＡｇＴ、ＧＭＰ１４０和ＧＰⅡ分别为３１％±１６％、１４％±８％，１９０±４９分子数／血小板和１４５％±３６％。在缓解期组，上述各项检测值分别为３３％±１３％、３８％±１６％、１７８±３３分子数／血小板和１３７％±４８％，而正常对照组则分别为２２％±８％、２９％±１３％和１２１±３０分子数／血小板和９６％±３１％。提示，在肺心病急性发作期ＰＡｄＴ、ＧＭＰ１４０、ＧＰⅡ水平明显高于正常对照组，在缓解期，ＰＡｄＴ、ＰＡｇＴ、ＧＭＰ１４０等均升高。结论慢性肺心病患者体内血小板被激活，血小板粘附、聚集、释放等功能增强。认识并纠正上述病理变化可能有助于肺心病疗效的提高。

Objective To study the platelet function in patients with chronic pulmonary heart disease. Method Subjects were divided into three groups (cor pulmonale exacerbation, cor pulmonale remission stage and normal control). Platelet adhesion rate (PAdT), platelet aggregation rate(PAgT), α granule membrane protein (GMP 140) and glycoproteinⅡ were measured by radioimmunoassay , flow cytometry and other methods. Result In cor pulmonale exacerbation , the values of PAdT , PAgT, GMP 140 and GPⅡ were 31%±16%, 14%±8%, 190±49 molecule / platelet and 145%±36% respectively. In cor pulmonale remission stage, the values were 33%±13%, 38%±16%, 178±33 molecule / platelet and 137%±48% respectivety. These findings showed that the values of PAdT, GMP 140 and GPⅡ in cor pulmonale exacerbation were markedly increased, whereas PAgT was significantly reduced. However , PAdT, PAgT, GMP 140 and GPⅡ in remission stage were all higher than that of normal group. Conclusion In vivo platelet activation is indeed present in patients with chronic pulmonary heart disease.