不同类型脑梗死急性期血小板功能变化研究

THE CHANGES AND SIGNIFICANCES OF PLATELET GMP-140 AND GMP-140 IN PLASMA IN PATIENTS WITH ACUTE CEREBRAL INFARCTION

目的 探讨脑梗死急性期血小板GMP－140、血浆GMP－140、血小板粘附率和聚集率的变化及意义。方法 对大灶脑梗死组（n＝22）、小灶脑梗死组（n=25）和腔隙性脑梗死组(n=20)病人进行研究，于发病后3d和2周采静脉血，采用酶联免疫吸附竞争法测定血小板GMP－140、联免疫吸附双抗体夹心法测定血浆GMP－140的浓度。结果 发病3d内大灶脑梗死组血小板GMP－140、血浆GMP－140浓度较对照组非常显著升高（P＜0.001），小灶脑梗死组和腔隙性脑梗死组血小板GMP－140、血浆GMP－140浓度也较对照组升高（P＜0.005－0.001），但无大灶脑梗死组升高明显（P＜0.05）；小灶脑梗死组与腔隙性脑梗死组无显著性差异（P＞0.05）；3组病人血小板粘附率（PAdT)和血小板聚集率(PAgT)均显著升高（P＜0.01）。发病2周时，3组病人血小板GMP－140、血浆GMP－140浓度均已明显下降，但仍较对照组高（P＜0.05）而PAdT和PAgT均降至正常或更低。结论 不同类型脑梗死急性期血小板处于显著的化状态。血浆GMP－140浓度PAdT和PAgT能更准确地反映血小板的活化状态。

Objective\ To explore the changes and significances of platelet granule membrane protein-140 (GMP-140),GMP-140 in plasma,PAdT and PAgT in patients with acute cerebral infarction.Methods\ The platelet GMP-140 was measured with enzyme-linked immunosorbent assay (ELISA) competitive method and GMP-140 in plasma by ELISA double antibody method in blood collecting in 3 d and 2 weeks after onset in large(n=22),small(n=25) size and lacuna (n=20) cerebral infarction groups.Results\ The platelet GMP-140,GMP-140 in plasma,PAdT and PAgT in large cerebral infarction group in 3 d after onset were much higher than control group (P<0.001),and the small size and lacuna groups were higher (P<0.05～0.001) than control but lower than large group (P<0.05).There was no differences between the small and lacuna groups (P>0.05).The PAdT and PAgT in 3 groups were higher (P<0.01).The platelet GMP-140 and GMP-140 in plasma in all 3 groups in 2 weeks after onset had been clearly lower but still higher than control group (P<0.05),the PAdT and PAgT were normal or even more lower.Conclusion\ Platelet activation was significant in different types acute cerebral infarction,the concentration of GMP-140 in plasma can reflect the degree of platelets activities more well and truly than PAdT and PAgT.