脑梗死患者和正常人血小板表面活化相关性抗原的体内外研究

Alterations of activation-dependent antigens on the platelet surface in vivo and in vitro

目的 :观察血小板活化后表面一些抗原决定簇的改变 ,探讨其在血栓性疾病研究中的意义。方法 :以凝血酶诱导 2 0例正常人血小板活化 ,应用流式细胞仪检测其血小板膜糖蛋白GPIb、Ⅲa、P 选择素的表达 ,纤维蛋白原结合以及瑞斯托霉素 (Risto)诱导的血小板粘附 ,同时用全血法测定脑梗死患者相应抗原的改变。结果 :随着凝血酶浓度 0 .0 0 1～ 0 .1U/ml递增瑞斯托霉素 (Risto)诱导的血小板粘附及GPⅠb表达逐渐下降 ,P 选择素与纤维蛋白原结合则在 0 .0 1～ 1U/ml间逐渐上升 ,GPⅢa无明显变化。 30例脑梗死患者GPⅠb显著下降 ,P 选择素的表达及纤维蛋白原结合远高于对照组 ,GPⅢa无变化。结论 :凝血酶以剂量依赖的方式分别对血小板的粘附、聚集与释放产生影响 。

Objective:To investigate the changes of antigens on the platelet surface following activation, and assess its significance in the study of thrombosis disease. Method:The expression of platelet membrane glycoproteins as well as the fibrinogen binding and the platelet agglutination induced by ristocetin were measured in 20 normal subjects whose platelets were activated by different thrombin. The same antigens were also analyzed in whole blood in 30 patients with cerebral infarction. Result:With the increase of thrombin concentration from 0.001 U/ml to 0.1 U/ml, the expression of paltelet membrane GPIb and agglutinability by ristocetin decreased gradually while the platelet membrane P selectin and fibrinogen binding increased with the change of thrombin from 0.01 U/ml to 1U/ml. In addition, the platelet membrane GPⅠb was lower, while the P-selectin and fibrinogen binding were higher in the patients with cerebral infarction than those in the normal group, GPⅢa was not significantly changed in all the samples. Conclusion:Thrombin affects platelets in a dose dependent manner, and the change of activation dependent antigens on the platelet surface could be an important index reflecting the platelet activation in vivo .