伴脑梗死颈动脉粥样硬化与血小板激活的关系

The correlation of carotid atherosclerosis with ischemic stroke and platelet activation

目的 探讨伴脑梗死颈动脉粥样硬化 (CAS)与血小板激活的关系。方法 采用流式细胞仪测定4 0例伴脑梗死CAS患者 (A组 )和 31例不伴脑梗死CAS患者 (B组 )外周血血小板膜糖蛋白Ⅱb Ⅲa复合物α亚单位 (CD4 1)、P 选择素 (CD6 2p)和溶酶体膜蛋白 5 3(CD6 3)的表达以及血小板与淋巴、单核和中性粒细胞的凝集性。结果 与B组相比 ,A组CD6 2p、CD6 3阳性百分率和血小板 单核细胞的凝集性升高 (P <0 .0 5 ) ;Spearman相关分析发现 ,A组CD6 2 p和B组CD4 1、CD6 2 p阳性百分率与CAS程度呈显著正相关 (P <0 .0 5 ) ;Logistic回归分析证实 ,血小板 单核细胞凝集性和CD6 2 p是CAS患者产生脑梗死的独立危险因素 (P <0 .0 5 )。 结论 血小板活性增高的CAS患者易发生缺血性脑血管病。

Objective To investigate the correlation of carotid atherosclerosis(CAS) with ischemic stroke and platelet activation. Methods By flow cytometry, the expressions of platelet membrance glycoprotein Ⅱb Ⅲa complex α subunit(CD41), P selectin (CD62p), lysosome membrance protein 53(CD63) and platelet lymphocyte, monocyte, neutrophil aggregates were measured in 40 CAS patients with ischemic stroke (group A) and 31 CAS patients without ischemic stroke (group B). Results Compared with group B, the positive percentage of CD62p, CD63 and platelet monocyte aggregates were elevated in group A (P <0.05). Spearman correlation analysis confirmed there was significant correlation between the expressions of CD62p in group A, CD41 in group B, CD62p in group B and the degree of CAS ( P <0.05). The Logistic regression analysis revealed platelet monocyte aggregates and CD62p were the independent risk factor in CAS with ischemic stroke( P <0.05).Conclusion CAS patients with high platelet activity are prone to have ischemic cerebral vascular disease.