急性脑梗死患者血小板超微结构及相关参数变化的研究

Ultrastructure and blood test indicators of platelets in patients with acute cerebral infarction

目的探讨急性脑梗死患者血小板超微结构及血小板相关参数的表达及意义。方法选择发病在6～24h的脑梗死患者30例为实验组，健康体检者30例为对照组，采用透射电镜观察血小板超微结构，比较两组患者之间的差异；采用全自动血细胞分析仪检测血小板平均体积（MPV）、血小板计数（PLT），并对血小板相关参数进行分析。结果实验组及对照组的MPV分别为（9.18±0.57）、（8.76±1.32）fl，（P〈0.05），PLT分别为[（173.75±62.18）×10^9／L]、[（231.86±58.25）×10^9／L]，（P〈0.05）；透射电镜下，实验组患者血小板形态不规则，伪足增多，多处可见血小板聚集、融合在一起，成片状；血小板膜多处破裂；颗粒明显减少，线粒体肿胀、空泡化。对照组血小板均匀分散存在、呈圆型或椭圆型，血小板膜表面光滑，伪足突起很少，α颗粒和线粒体较多，少有空泡样改变结论急性脑梗死患者MPV升高，PLT下降，血小板超微结构显著改变，是导致脑血管急性事件的血小板病理改变基础。

Objective To observe the platelet ultrastructure and platelet-related parameters in patients with acute cerebral infarction. Methods Thirty patients with infarction of the cerebral median artery admitted within 6-24h after onset （CI group）, and 30 healthy adults （control group） were included in the study. Platelet ultrastructure was observed with transmission electron microscopy; the mean platelet volume （MPV） and platelet count （PLT） were determined by automatic blood cell analyzer in both groups. Results The MPV in CI group and control group was （9.18± 0.57）fl and （8.76± 1.32）fl （P〈0.05）; PLT was （173.75 ± 62.18） ×10^9/L and （231.86± 58.25） × 10^9/L （P〈0.05）. Electron microscopy showed that the ultrastructural changes of platelets was evident with more pseudopodium, aggregation and fusion, more disruption of platelet membrane, fewer alpha gran- ules and also mitochondria, the remains of which demonstrated swell and vacuolization in CI group. Conclusion The results show that MPV is increased and PLT reduced in patients of acute cerebral infarction, and the platelet ultrastructural changes are significant, which may be the pathological basis of acute cerebrovascular events.