股骨头缺血性坏死患者血小板微颗粒及血小板膜糖蛋白GP Ⅱb/Ⅲa、P-选择素表达的相关性研究

Detection of the relationship of ischemic osteonecrosis of the femoral head with platelet-derived microparticle and expression of GP Ⅱb/Ⅲa and CD62P

[目的]检测股骨头缺血性坏死患者血小板微颗粒(PMP)数量的变化,研究其与血小板表面膜糖蛋白GP Ⅱb/Ⅲa(PAC-1)、P-选择素(CD62P)活化比率的关系,探讨其在股骨头缺血性坏死患者中的临床意义。[方法]采用流式细胞仪分别对INFH及健康对照组(各40例)富含血小板血浆进行检测,分析各组PMP的表达状况,PAC-1及CD62P的活化比率;全自动生化仪检测血脂指标,包括总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、载脂蛋白A1、载脂蛋白B;凝血功能指标,包括血浆凝血酶原时间、活化部分凝血酶时间、凝血酶原国际标准化比值以及C反应蛋白水平。[结果]INFH患者中PMP的表达,PAC-1及CD62P的活化率[分别为130.4±58.6/Plt,(47.5±17.4)%,(25.8±7.1)%]明显高于健康对照组[分别为67.7±14.8/Pit,(9.2±2.4)%,(4.1±1.2)%](P<0.01);相关分析显示PMP与INFH存在相关(r=0.34,P<0.01),PMP与PAC-1、CD62P及CRP存在明显的正相关(分别为r=0.28,P=0.03,r=0.61,P<0.01及r=0.15,P=0.04)。[结论]PMP数量及PAC-1、CD62P活化率等可作为INFH重要的实验室诊断依据,对诊疗INFH具有重要的参考价值。

[Objective] To detect the relationship of ischemie osteonecrosis of the femoral head （INFH） with their plasma platelet - derived microparticle （PMP） , activation ratio of glycoprotein Ⅱb/Ⅲa （ PAC - 1 ） and P - selection （CD62P） , and to investigate the function and clinical significance of the activation of PMP, PAC - 1, and CD62P in patients with INFH. [Methods] The quantity of PMP and activation ratio of PAC - 1 and CD62P were measured in the volunteer of the INFH group and health control group using flow cytometry. Blood - lipid indicators （ such as total cholesterol, triglycerides, high density lipoprotein, low - density lipoprotein, apolipoprotein B, and apolipoprotein A1 ） , coagulation indicators （ including prothrombin time, activated partial thromboplastin time, prothrombin international normalized ratio）, and plasma C - reactive protein concentration were measured by automatic - biochemical analyzer. E Results ] The quantity of PMP and activation ratio of PAC -1 and CD62P in INFH group [ 130. 4 ± 58.6/Pit, （47.5 ± 17.4 ） %, and （25. 8 ± 7. 1 ） % respectively] were significantly higher than health control group E 67.7 ± 14. 8/Pit, （9.2 ± 2.4） %, and （4. 1 ± 1.2） % respectively ] （p 〈 0. 01 ） . Correlation analysis showed that there was a significant association between high plasma PMP quantity and the development of INFH （ r = 0. 34,P 〈 0. 01 ）, and there was significantly positive correlation between the quantity of PMP and activation ratio of PAC - 1 and CD62P, and levelofCRP （r=0.28, P=0.03, r=0.61, P〈0.01, and r=0. 15, P=0. 04 respectively） . [Conclusion] The levels of PMP, PAC - 1 and CD62P can be taken as the specificity laboratory indicates for clinical diagnosis of 1NFH.