静脉高压对慢性静脉功能不全患者血小板活性的影响

Effect of venous hypertension on platelet reactivity in patients with chronic venous insufficiency

目的观察体位变化和压力对下肢慢性静脉功能不全（CVI）患者血小板活性的影响。方法根据纳入和排除标准，选择24例CVI患者作为实验组和20例正常人作为对照组，采用酶联免疫吸附法（ELISA）测定两组人群在不同体位时下肢静脉血液、肘部静脉血液及在外在压力持续作用60min后血小板P-选择素表达水平。结果晨起平卧位及站立30min后两组下肢静脉血液血小板P-选择素表达水平差异无统计学意义（P〉0．05）；在90～100mmHg（1mmHg=0．133kPa）压力作用60min后，CVI患者的下肢静脉血液和肘部静脉血液血小板P-选择素均明显高于对照组（P〈0．01）。结论CVI患者血小板对压力具有高反应性，可能是CVI发病的重要机制之一。

Objective To investigate the effect of venous pressure and different postures on plate- let reactivity in patients with chronic venous insufficiency （CVI）. Methods According to included and excluded criteria, anticoagulated blood from superficial venous blood at the level of dorsum of foot and elbow was obtained from 24 patients with CVI and 20 normal control subjects in different postures with or without simulated venous hypertension in vitro. The washed platelet plasma from anticoagulated blood samples was analyzed for P-selectin by enzyme-linked immuosorbent assay （ELISA）. Results From supine position to standing position, there was no statistically significant variance in P-selectin of washed platelet plasma between different subjects （ P 〉 0. 05 ）. After 60 min of simulated venous hypertension in vitro, whatever anti- coagulated blood samples from superficial venous blood at the level of dorsum of foot or elbow, P-selectin from washed platelet plasma was significantly increased in patients with CVI as compared with normal control subjects （P 〈 0.01 ）. Conclusion Platelet hyper-reactivity in patients with CVI, resulted from venous hypertension, may play a major role in the pathogenesis of CVI.