调脂过程中血小板超微结构和P-选择素的变化及关系

Changes and Relation of Platelet Ultrastructure and Expression of P-selectin After Treatment in Patients with Hypercholesterolemia

目的:研究高胆固醇血症(HC)患者治疗前后血小板超微结构和血小板颗粒膜糖蛋白P-选择素表达的动态变化以及二者的关系。方法:选择HC患者20例,男7例,女13例,平均年龄52岁,口服普伐他汀10～20 mg/d,疗程4～8周。治疗前后在透射电镜下观察血小板的超微结构并进行立体计量分析,同时测定血小板颗粒膜糖蛋白P-选择素表达的变化。结果:HC患者服用普伐他汀4～8周后血清总胆固醇和低密度脂蛋白水平及血小板P-选择素表达水平明显下降,同时血小板形态结构的立体计量学参数得以改善。结论:治疗后HC患者血小板颗粒膜糖蛋白P-选择素表达的下降与血小板形态结构的恢复有关;而普伐他汀对血小板的这种良性影响,可能是其降脂以外,参与并促进动脉粥样斑块消退的多种机制之一。

Objective: To study the changes of platelet infrastructure and expression of P-selectin after treatment with pravastatin in patients with hypercholesterolemia(HC) and relation between them. Methods: 20 patients with HC were selected and treated with pravastatin 10-20 mg/d for 4-8 weeks. The changed platelet ultrastructure were observed by electron microscopic and analysed with quantitative stereo-logic method. The expression of platelet P-selectin was detected by flow cytometry. Results: After 4-8 weeks treatments, the levels of serum total cholesterol(TC) and expression of platelet P-selectin were lowered and most of platelet quantitative stereologic parameters were improved. Conclusion: The changes of expression of platelet granule membrane glycoproteins in HC can be corrective with the improvement of platelet ultrastructure and quantitative sterologic parameters with pravastatin therapy. Pravastatin, in addi-tiont to its plasma cholesterol lowering ability, its inhibitory effect on platelet may be one of its mechanisms of enhancing atherosclerosis regression.