巴曲酶对急性缺血性脑卒中患者血小板功能的影响

Effect of bartroxobin on platelet function of patients with acute ischemic stroke

目的 观察巴曲酶治疗对急性缺血性脑卒中患者外周血血小板膜糖蛋白和血小板 白细胞凝集性的影响。方法 治疗组 2 8例 ,予巴曲酶 2 0BU( 1BU =0 .17NIH凝血酶单位 )治疗 3d ;对照组 2 5例 ,除未予巴曲酶外 ,用药同治疗组。采用流式细胞仪测定脑卒中发病后 2 4h内、4 8h和 72h后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)的表达及血小板与淋巴、单核和中性粒细胞的凝集性。结果 与对照组相比 ,治疗组脑卒中患者发病 4 8h后血小板CD6 2 p的表达升高 ,发病 72h后巴曲酶CD4 1、CD6 2 p和CD6 3的表达及血小板 白细胞凝集性均无变化。 结论 巴曲酶治疗可激活血小板 。

Objective To observe the changes of platelet membrance glycoprotein and platelet leucocyte aggregates in the peripheral blood of patients with acute ischemic stroke after treatment with bartroxobin. Methods The treated group was given bartroxobin 20 BU for three day(28 cases); the control group was similarly treated but without bartroxobin(25 cases). The expression of platelet membrance glycoprotein Ⅱb Ⅲa complex α subunit(CD41), P selectin(CD62p), lysosomes membrance protein 53(CD63) and platelet lymphocyte, monocyte, neutrophil aggregates were measured by cytometry in consecutive patients(within 24 hours and 48, 72 hours after onset of stroke).Results Compared with the control group, the percentage of positive CD62p was elevated in bartroxobin treated group 48 hours after onset of stroke ( P <0.05). No difference in percentages of positive CD41, CD62p, CD63 and platelet leucocyte aggregates were detected 72 hours after onset of stroke.Conclusion Treatment of acute stroke with bartroxobin may lead to platelet activation, which implicates the necessity of giving anti platelet drug together with bartroxobin.