全身炎症反应综合征患者血小板活化与炎症反应的相关性研究

Relationship between blood platelet activation and imflammation reaction in patients with systemic inflammatory response syndrome

目的研究全身炎症反应综合征(SIRS)患者急性期反应血小板活化水平与炎症反应标志物C-反应蛋白(CRP)、内毒素含量的相关性,并探讨其临床意义。方法对28例符合SIRS诊断的病人,入院后第1、3和5天凌晨空腹抽取肘静脉血8ml。采用流式细胞技术检测血浆中的血小板糖蛋白P-选择素/血小板质膜蛋白(CD62P/CD61);应用速率散射免疫比浊法测定CRP浓度和基质偶氮显色鲎试验测定法测定内毒素含量,并设健康对照组。结果 SIRS患者血浆中CD62P/CD61水平较对照组明显升高(r分别=0.87、0.82、0.78,P均<0.05);CRP浓度在入院后第1天即达高峰,并持续升高,与对照组比较,差异有统计学意义(r分别=0.94、0.92、0.91,P均<0.05);内毒素含量入院后第3天达高峰,比CRP延后升高,与对照组比较,差异有统计学意义(r=0.91、0.96、0.93,P均<0.05)。CD62P/CD61水平与CRP浓度、内毒素含量有显著的相关性(r=0.80,P<0.05)。器官功能不全组患者血浆CD62P/CD61水平、CRP浓度与内毒素含量均显著高于器官功能正常组患者(r=0.76、0.68、0.84,P均<0.05)。结论 SIRS患者炎症反应时血浆CD62P/CD61、CRP和内毒素水平明显升高,CD62P/CD61与CRP、内毒素呈正相关。

Objective To investigate the relationship between activation blood platelet,serum C-reactive protein（CRP） and plasma endotoxin in patients with systemic inflammatory response syndrome（SIRS）.Methods A total of 28 patinets with confirm diagnosis of SIRS were enrolled in the study.Venous blood samples were collected at the morning of the first day,the third day and the fifth day of inclusion in the study.Plasma platelet glycoprotein P-selectin/platelet cytolemma protein（CD62P/CD61） was determined by Flow CytoMeter（FCM） measurement.Serum CRP and plasma endotoxin were also measured at the same monitoring sites.Blood samples from health people were carried as control group.Results Levels of plasma CD62P/CD61 had the significant difference with the control groups（r =0.87,0.82,0.78,P0.05）.Serum CRP got peak level at the first day and plasma endotoxin had reach the peak level two days later.Both of above had the significant difference with the control groups（r=0.91,0.96,0.93,P0.05）.Levels of plasma CD62P/CD61,Serum CRP and plasma endotoxin had significant dependability（r=0.80,P0.05）.They were higher in the group of organ malfunction than that in the one of normal organ function（r=0.76,0.68,0.84,P0.05）.Conclusions Levels of plasma CD62P/CD61 and CRP and endotoxin had the significant difference in acute inflammation reaction of patients with SIRS.Levels of plasma CD62P/CD61,serum CRP and plasma endotoxin had significant dependability.