蝙蝠葛碱对二尖瓣狭窄患者血小板膜糖蛋白Ⅳ再分布的影响

Effect of Dauricine on Redistribution of Glycoprotein Ⅳ in Platelet Membrane of Patients with Mitral Stenosis

目的 :探讨蝙蝠葛碱对二尖瓣狭窄 (mitralstenosis,MS)患者血小板不可逆聚集的影响。方法 :用流式细胞仪测定MS患者 (1 6例 )动脉血静息状态及凝血酶 (0 0 5U/ml、0 1U/ml、0 5U/ml、1 0U/ml)激活时 ,血小板膜表面糖蛋白Ⅳ (GPⅣ )及凝血酶敏感蛋白(TSP)分布状况 ,并与健康人 (1 4名 )比较。结果 :静息状态时MS患者血小板膜表面GPⅣ分布显著高于健康人 (P <0 0 1 ) ,而血小板膜表面TSP分布与健康人无显著性差异 (P >0 0 5 ) ,激活状态时MS患者血小板膜表面GPⅣ、TSP分布明显高于健康人 (P <0 0 5 ,P <0 0 1 ) ;蝙蝠葛碱 (5 0 μmol/L)可显著抑制凝血酶诱导的血小板膜GPⅣ再分布 (P <0 0 5 ,P <0 0 1 ) ,仅抑制较低浓度 (0 0 5U/ml,0 1U/ml)凝血酶诱导的血小板内TSP释放 (P <0 0 5 ,P <0 .0 1 ) ,而对较高浓度 (0 5U/ml,1 0U/ml)凝血酶诱导的TSP释放无抑制作用。结论 :MS患者动脉血血小板活性及对凝血酶的反应性增高 ,蝙蝠葛碱可降低MS患者血小板不可逆聚集的危险性。

Objective: To investigate the effect of dauricine on the irreversible platelet aggregability of patients with mitral stenosis (MS). Methods: Glycoprotein Ⅳ (GPⅣ) and thrombospondin (TSP) levels on the membrane surface of the stationary platelet or platelet activated by thrombin (0.05 U/ml, 0.1U/ml, 0.5U/ml, 1.0U/ml) in 16 patients with MS were measured with flow cytometric method and compared with those of the healthy (14 cases). Results: The GPⅣ level of stationary platelet, the GPⅣ and TSP levels of activated platelet in MS patients were higher than those in the healthy significantly (P<0 01), while the TSP level of stationary platelet was not different between the patients and the healthy (P>0 05). The GPⅣ redistribution on the activated platelet surface was apparently inhibited by dauricine (50μmol/L,P<0 05,P<0.01) and the release of TSP from intracellular α granules was inhibited by dauricine only in the activated platelets induced by thrombin of low concentration (0.05U/ml and 0.1U/ml, P<0 05,P<0.01), inhibiting effect was not found in those activated with high concentration of thrombin. Conclusion: The activity and reactivity to thrombin of platelets increased in MS patients, and dauricine was able to reduce the occurrence of the irreversible platelet aggregation in MS patients.