血小板活性与老年慢性肺心病高凝状态的关系

The relation between platelet activation and hypercoagulability in elderly patients with chronic cor pulmonary exacerbation

目的:探讨老年慢性肺心病急性加重期患者血小板膜糖蛋白GPⅡb/Ⅲa、CD62p的变化与纤维蛋白原(FG)、D-二聚体(DD)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,并检测患者FG、DD水平,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、FG、DD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)。老年慢性肺心病急性加重期组GPⅡb/Ⅲa、CD62p与FG、DD均呈正相关。结论:老年慢性肺心病急性加重期患者血小板明显活化,其活化程度与高凝状态关系密切。

Objective： To investigate the relation among platelet activation marker（ GP Ⅱ b/Ⅲ a, CD62p） and amounts of fibrinogen （FG） and of D-dimer （DD） in elderly patients with chronic cor pulmonale exacerbation.Methods：Subjects were divided into four groups （42 elderly patients with chronic cor pulmonale exacerbation, 42 elderly patients with chronic cor pulmonale remission stage, 30cases of healthy elderly controls and 30 cases of healthy non-elderly controls）. Positive rates of GP Ⅱb/Ⅲ a and CD62p were measured with tricolor flow cytometry. We also determined FG and DD in patients with chronic cor pulmonale and in normal controls. Results： Compared with those of chronic cor pulmonale remission stage group, healthy elderly group and healthy non-elderly group, the levels of GP Ⅱ b/Ⅲ a, CD62p, FG and DD increased significantly in elderly patients with chronic cor pulmonale exacerbation （ all P 〈 0. 001 ）. There was a positive correlation between the amount of GP Ⅱ b/Ⅲ a or CD62p and the amount of FG and DD in elderly patients with chronic cor pulmonale exacerbation. Conclusion： There is increased coagulation and platelet activity in elderly patients with chronic cor palmonale exacerbation, and there is a significant correlation between platelet activity and hypercoagulability.