恶性肿瘤患者血小板聚集与胞浆游离钙变化

Platelet Aggregation in Malignant Tumors and Cytosolic Free Calcium Changes

目的通过测定恶性肿瘤患者血小板功能,探讨血小板在恶性肿瘤发病中的作用。方法采用Fura-2/Am荧光双波长测定胞浆游离钙([Ca2+]i)技术观察恶性肿瘤患者静息状态及二磷酸腺苷(ADP)激动后的血小板[Ca2+]i变化;采用血小板聚集仪测定血小板最大聚集率。结果 (1)恶性肿瘤患者血小板最大聚集率(PAGmax)为(0.92±0.08),较正常对照组(0.70±0.06)明显增高(P<0.05);(2)恶性肿瘤患者静息血小板[Ca2+]i为(134.28±27.9)nmol/L,较正常对照组(90.43±21.13)nmol/L明显增高(P<0.05);(3)恶性肿瘤患者血小板PAGmax与静息血小板[Ca2+]i呈正相关;(4)ADP激动的血小板峰位[Ca2+]i为(481.38±136.55)nmol/L,比正常对照组(253.34±32.26)nmol/L增高(P<0.05),其中恶性肿瘤患者钙释放和钙内流均高于对照组。结论恶性肿瘤患者常有血小板功能异常,说明血小板在恶性肿瘤的发病中起重要作用,尤其在转移和血栓形成中起重要作用,抗血小板治疗以抑制血小板钙内流或钙释放可让肿瘤患者受益。

Objective To explore the platelet role in the pathogenesis of malignant tumors by measuring the platelet function in malignant tumor. Methods Fura-2 fluorescent technique was used to detect intracellular free calcium （[Ca^2＋]i）,and the platelet [Ca^2＋]i changes in malignant tumors in resting and after ADP-stimulation were observed,and the platelet aggregation device was used to measure the maximum aggregation of platelet （PAGmax） from 32 cases of malignant tumors and 30 cases normal controls. Results （1）he PAGmax and resting platelet [Ca^2＋]i of tumor group （n=32） were （0.92±0.08） and （134.28 ± 27.9）nmol/L,respectively,both being higher than those of control group（P〈0.05）. （2）There was an obviously positive correlation between PAGmax and resting platelet [Ca^2＋]i. （3）The platelet [Ca^2＋]i level in malignant tumors excited by ADP was （481.38± 136.55）nmol/L was higher than that of normal group （P〈0.05）. Both Ca^2＋ influx and platelet Ca^2＋ release in malignant tumors were higher than those of normal group. Conclusion The platelet functions are abnormal in malignant tumors,suggesting platelets play an important role in the pathogenesis of malignant tumors, especially in tumor metastasis or in its thrombotic complications. Antiplatelet therapy may be useful for tumor patients.