造血干细胞移植预处理对血小板膜糖蛋白表达和聚集功能的影响

Investigation of Platelet Membrane Glycoprotein Expression and Platelet Aggregation Function During the Conditional Treatment in Patients Undergoing Hematopoietic Stem Cell Transplantation

目的研究造血干细胞移植预处理对血小板膜糖蛋白表达和血小板聚集功能的影响。方法应用血小板聚集仪检测29例造血干细胞移植患者预处理前后ADP诱导的血小板聚集功能变化,同时用流式细胞仪观察血小板膜糖蛋白(GP)Ⅰb、Ⅱb、Ⅲa和CD62P表达水平的改变。20名健康人为正常对照。结果移植患者预处理前血小板对ADP的最大聚集率为(56.73±20.38)%,和正常人的(57.66±12)%相比,无明显差异(P>0.05);预处理后血小板对ADP的最大聚集率降至(31.38±25.81)%,与预处理前比较,差异显著(P<0.01)。GPⅡb、GPⅢa与CD62P在预处理后较正常组及预处理前明显升高(P<0.05),GPⅠb变化不明显。预处理过程中血凝常规无明显改变。结论造血干细胞移植预处理会引起血小板的活化,导致血小板聚集功能与血小板膜GP的改变,这可能是导致出血或血栓等并发症的原因之一。

Objective To investigate the effects of conditioning treatment for hematopoietic stem cell transplantation （HSCT） on platelet membrane glycoprotein （GP） expression and platelet aggregation function. Methods Platelet aggregation induced by ADP was tested in 29 patients undergoing HSCT in the course of conditioning treatment. The expressing of GPIb ,GPHb, GPma and CD62P before and after conditioning treatment for HSCT were detected using a flow cytometer. Tweenty healthy volunteers were selected as the control subjects. Results There was no significant difference in the level of the maximal platelet aggregation induced by ADP between the patients before conditioning treatment[ （56.73±20. 38） % ] and the normal subjects [ （ 57.66 ±12） % ] （ P 〉 0.05 ）. While the maximal platelet aggregation rate after conditioning treatment [ （31.38±25.81 ） % ] induced by ADP was significantly lower （P 〈0.05）. The expressions of platelet membrane GPIIb, Ilia and CD62P post conditional treatment were higher than those in the control group or pre-conditional treatment, GPIb didn＇t changed at the same time. There was no alteration of coagulation parameters after conditioning treatment. Conclusion The conditioning treatment for HSCT induces the activation of platelet, leading to the alterations of platelet aggregation and platelet membrane glycoprotein expression, which may be one of the pathogenetic reasons for the complications of bleeding or thrombosis.