Effect of Xiaoyu Zhixue Tablet (消瘀止血片) on Expression ofPlatelet Membrane Glycoproteins in Patients withHemorrhagic Thrombopathy

Objective: To observe the effect of Xiaoyu Zhixue tablet (消瘀止血片,XYZXT) on the expression of platelet membrane glycoproteins in patients with hemorrhagic thrombopathy, and to explore its possible mechanism. Methods: The total of 148 patients with hemorrhagic thrombopathy were randomly divided into two groups, the traditional Chinese medicicne (TCM) group (n=98) treated with XYZXT and the Western medicine (WM) group (n=50) treated with adrenosin, vitamins C, K and P, both for 6 months. The therapeutic effect and the recovery rate of platelet aggregation in the two groups were observed. And platelet membrane glycoprotein (GP) Ⅰb/Ⅸ, GPⅡb/Ⅲa complexes, GPⅠb, GPⅡb, GP Ⅲa and P-selectin were analyzed by flow cytometry in both groups before and after treatment and also in 34 normal healthy subjects. Results: The total effective rate of hemostasis was 89. 8% in TCM group and 54. 0% in the WM group (x2=45.83, P<0.01), and the recovery rate of platelet aggregation was 72.4% and 4.0% respectively (x2=62.06, P<0.01). The fluorescence intensity of GP Ⅰ b/Ⅸ, GPⅡb/Ⅲa complexes, GPⅠb, GPⅢa and P-selectin were lower in both groups before treatment than those in the healthy subjects. Expression of above-mentioned marks was elevated in TCM group after 6 months' therapy, which was insignificantly different as compared with the healthy subjects (P>0.05) and higher than those in the WM group (P<0.05). Conclusion: One of the mechanisms in treating hemorrhagic thrombopathy with XYZXT is that it could regulate the expression of GP Ⅰb/Ⅸ, GPⅡ b/Ⅲa complexes, GPⅠb, GPⅢa and P-selectin at the level of receptor protein.

Expression of Platelet Membrane Glycoprotein Ib/Ⅸ/Ⅴ Complex,a Receptor of Thrombin,in Patients with Hemorrhagic Thrombopathy

To investigate the role of platelet membrane glycoprotein （GP） Ib/Ⅸ/Ⅴ complex and its subunit GP Ibα in patients with hemorrhagic thrombopathy （HT）, the expressions of GP Ib/Ⅸ/Ⅴ complex and GP Ibα,defined as mean fluorescence intensity （MFI）, were assessed by flow cytometry. The maximum aggregation of platelet was determined by turbidity method. These indicators were compared among 68 HT patients with the presenting complaint of hemorrhage, 33 well-controlled HT patients and 32 normal healthy subjects. The results showed that the MFI of GP Ib/Ⅸ /Ⅴ complex and GP Ibα was markedly lower in HT patients with current hemorrhage than that in the healthy subjects, with difference being statistically significant （P〈0.05）. There was no significant difference in the expressions of GP Ib/ Ⅸ/ Ⅴ complex and GP Ibα between well-controlled HT patients and normal healthy subjects （P〉0.05）. It was concluded that the expression of GP Ib/Ⅸ /Ⅴ complex, the receptor of thrombin and von Willebrand factor, was down-regulated in HT patients with current hemorrhage, which might result in the dysfunction of platelet aggregation and recurrence of HT.

Association of the Platelet Membrane Glycoprotein Ⅰa C807T Gene Polymorphism with Aspirin Resistance

To explore the correlation between the C807T polymorphism of platelet membrane glycoprotein Ⅰa （GP Ⅰa） gene and aspirin resistance in Chinese people, 200 patients with high-risk of atherosclerosis took aspirin （100 mg/d） for 7 days. Platelet aggregation function was detected using adenosine diphosphate （ADP） and arachidonic acid （AA） before and after the administration of aspirin. Then the subjects were divided into three groups according to the results of platelet aggregation function： an aspirin resistant （AR） group, an aspirin semi-responder （ASR） group and an aspirin-sensitive （AS） group. Platelet GP Ⅰa gene 807CT polymorphism was examined by means of polymerase chain reaction-sequence specific primers （PCR-SSP）. The results showed that T allelic frequency in AR group and ASR group were higher that of AS group （P〈0.005）, and the prevalence of genotypes （TT＋TC） of these two groups was significantly higher than that in AS group （P〈0.05）. Platelet GP Ⅰa T allele was significantly associated with aspirin resistance as revealed by multiple logistic regression （OR=3.76, 95% CI： 2.87-9.58）. The results suggest that inherited platelet GP Ⅰa variations may have an important impact on aspirin resistance and the presence of GP Ⅰa T allele may be a marker of genetic susceptibility to aspirin resistance.

Redistribution of Platelet Membrane Glycoprotein IV and Release of Intracellular α-granule Thrombospondin in Patients with Chronic Myelogenous Leukemia

The redistribution of platelet membrane glycoprotein IV (GPIV) and the release of intracellular Q-granule thrombospondin (TSP) were examined and the inhibition of 5-thromboglobulin (&TG) and platelet factor 4 (PF4) in patients with chronic myelogenous leukemia (CML) was observed and quantitation of β-TG and PF4 in sera was conducted. GPIV in inactive platelet from CML was 36080±17010 molecules/platelet as compared with 13190±4810 from the controls (P<0,01), No abnormality was found in the distribution of platelet membrane GPIb and GPIIb/III.(P>0. 05). The GPIV redistribution on active platelet membrane induced thrombin (1U/ml) from CML and healthy donors was 44320132310 and 228001 12700 molecules/platelet respectively (P<0. 01 ). The difference in the release of intracellular Q-granule TSP between CML and the control group was not found (P>0.05). There was no direct correlation between GPIV expression and TSP binding after platelet activation. The high leveIs of β-TG and PF4 in sera inhibited release of intracellular a-granule TSP in vitro. These results indicate that the abnormality of platelet membrane GPIV is a common marker in CML, therefore the specific increase of platelet GPIV in patients with CML may be a useful tool for the diagnosis and monitoring of the platelet dysfunction. The release of interna1 TSP pools is hindered by either β-TG or PF4 in sera.

Considerations on Blood Platelets: A Neuron’s Mirror for Mood Disorders?

This work aims to be a reflection concerning a remarkable similarity between platelet and neuron. Through a series of experimental tests which have affected the fatty acid composition of the membrane of platelets, it was possible to provide a contribution to the scientific literature, which had already reported strong similarities between platelet and neuron. The work performed could be of great interest to investigate, by studying the interactome of the platelet, the molecular behavior of the neuron.

Effect of Xiaoyu Zhixue Tablet(消瘀止血片) on the Expression of Platelet Membrane Glycoprotein Ⅰb/Ⅸ/Ⅴ Complex in Patients with Chronic Renal Failure

Objective： To investigate the effect of Xiaoyu Zhixue Tablet （消瘀止血片, XYZXT） on the expression of platelet membrane glycoprotein （GP） Ⅰ b/Ⅸ/Ⅴ complex and GP Ⅰ b α in patients with chronic renal failure （CRF） in early metaphase. Methods： Fifty-one patients with CRF in early metaphase （treated group） were treated with XYZXT, 3 months as the course of treatment for 2 courses. The previous therapies remained unchanged. Flow cytometry was used to assess the expression of platelet GP Ⅰb/Ⅸ/Ⅴ complex and GP Ⅰb α in patients with CRF, and turbidity method was used to determine the platelet maximum aggregation rate （MAR）, meanwhile the renal function was measured. The final data were compared with those before the treatment, and with those in the normal control group （31 healthy subjects）. Results： Compared with the normal control group, expressions of GP Ⅰ b/Ⅸ/Ⅴ complex and GPⅠb α, and platelet MAR in CRF patients were significantly lower （P=0.007,P=0.001,P=0.009） before the treatment; after the treatment with XYZXT, the above indexes in CRF patients were remarkably increased （P=0.033,P=0.026, P=0.045）, but still lower than those in the normal control group, however, it was not statistically significant. Conclusion： （1） The expression of GP Ⅰ b/Ⅸ/Ⅴ complex in CRF patients of early metaphase was decreased, which lead to platelet aggregation dysfunction. This might be one of the reasons for the hemorrhagic trend in CRF. （2） XYZXT was able to upgrade expressions of GP Ⅰb/Ⅸ/Ⅴ complex and GPⅠb α in CRF patients, improve platelet function and clown-regulate platelet activation in patients with CRF.

Effect of the Principle of Activating Blood Circulation to Break Stasis on GMP-140 and D_2 Dimer in Patients with Acute Cerebral Infarction

Objective: To explore the clinical efficacy of the principle of activating blood circulation to break stasis (ABCBS) and its influence on platelet membranous protein particle (GMP-140) and D 2 dimer (D-dimer) before and after treatment. Methods: Eighty-eight patients with blood stasis syndrome (BSS) of acute cerebral infarction (ACI) were randomly divided into two groups, both of which were treated with conventional treatment, i.e. with western medicine (WM), with Salvia injection added through intravenously dripping.One of the two groups was used as the control and the other group as the treated group who had ABCBS herbs orally taken in addition. The duration of treatment course for both groups was 3 weeks. Results: There were changes in both groups over clinical symptoms, nerve function deficit scoring and GMP-140, D-dimer, but the treated group showed significantly better than that of the control group, ( P <0.05). Conclusion: ABCBS principle could serve as an important auxiliary treating method for BSS of ACI, as it can effectively alter the blood of ACI patients which was viscous, condense, coagulant and aggregating.

Platelet activation and the protective effect of aprotinin in hepatolithiasis patients

OBJECTIVE: To explore platelet activation and the protective effect of aprotinin in patients with hepatolithiasis. METHODS: The count of plaletets and levels of CD_(62P) and CD_(63) were measured by flow cytometry in 38 patients with hepatolithiasis. Several measurements were carried out after treatment with aprotinin. RESULTS: The levels of CD_(62P), CD_(63) in patients with hepalolithiasis were higher than those in patients with cholecystolithiasis (P<0.05), but the count of platelets was lower (P<0.05). After operation, the levels of CD_(62P), CD_(63) were significantly increased in patients with hepatolithiasis, but the count of platelets was lower (P<0.05). Postoperative levels of CD_(62P), CD_(63) were significantly lower in patients treated with aprotinin than in normal controls (P<0.05); but there was no significant change in the count of platelets in the two groups. CONCLUSION: Platelet activation occurs in patients with hepatolithiasis, and may be inhibited by aprotinin.

Effect of the Esters of Gallic Acid on Model and Human Blood Platelet Membranes Studied by Fourier Transform Infrared Spectroscopy

Gallic acid is one of the components of Chinese herbal drug Radix paeoniae used for promoting blood circulation to remove blood stasis. This paper studied the effects of gallic acid and its esters (e.g. ethyl, propyl, isobutyl and butyl gallate) on model and human blood platelet membranes by FTIR which was used for monitoring the physical state of the acyl chain, interfacial and head group region of the membrane lipid bilayer. From the experimental results it can be seen that the gallic acid and its esters have the modifying function on the pure and cholesterol-containing DPPC model membranes, and have the quantity-effective and structural-effective relationships. In addition, it is discovered that these esters have the modifying effect on the structure of human blood platelet membrane and can reverse the effect of ADP. That the effect of the esters of gallic acid counteracts the effect of cholesterol and ADP on human blood platelet perhaps provides a new explanation of the mechanism of Chinese herbal drugs used for promoting blood circulation to remove blood stasis.

Diagnosis of Disorders of Platelet Function by Flow Cytometry

The platelet membrane glycoprotein (GP)Ⅱ b/Ⅲ a, GPIX were detected by immunogold assay and flow cytometry, respectively, in two cases of Glannzmann's thrombasthenia (GT). The immunogold assay showed that the GPⅡ b/Ⅲ a gold granules in GT were decreased obviously, compared with that in normal controls. Flow cytometry results showed that GPⅡ b/Ⅲ a in two cases of GT was 0.1 % and 0.5 % of normal control, respectively. While GPIX showed no difference between the GT and normal control. The patients' father showed no bleeding symptoms, whose GPⅡ b/Ⅲ a accounted for 36.99 % of normal control. The experiment results suggested that flow cytometry is a quick, simple and sensitive method for the diagnosis of GP disorders.

MECHANISM OF PRESERVING EFFECT OF APROTININ ON PLATELET FUNCTION DURING CARDIOPULMONARY BYPASS

The deficiency of platelet function is the main defect of hemostatic mechanism during cardiopulmonary bypass (CPB), which attributed to the postoperative bleeding complication to a great extent. The proteinase inhibitor aprotinin was reported to have preserving effect on platelet adhesion during CPB. In this clinical reserch we found that CPB caused plasma alpha 2-antiplasmin decreasing, indicating the fibrinolytic system activation. Meanwhile, the ristocetin-induced aggregation declined to 39.6% and platelet GPIb decreased to 50% of preoperative value. However, by treatment with aprotinin, the plasma alpha 2-antiplasmin during CPB did not change, platelet aggregation was improved and platelet GPIb was preserved, and consequently resulted in a 46% lower blood loss postoperatively. These results confirmed that aprotinin could inhibit the fibrinolysis during CPB, and thus relieve the platelet damage and improve the postoperative hemostatic mechanism.

Effect of Dauricine on Redistribution of Glycoprotein Ⅳ in Platelet Membrane of Patients with Mitral Stenosis

Objective: To investigate the effect of dauricine on the irreversible platelet aggregability of patients with mitral stenosis (MS).Methods: Glycoprotein Ⅳ (GPⅣ ) and thrombospondin (TSP) levels on the membrane surface of the stationary platelet or platelet activated by thrombin (0. 05 U/ml, 0. 1 U/ml,0. 5 U/ml, 1. 0 U/ml) in 16 patients with MS were measured with flow cytometric method and compared with those of the healthy (14 subjects). Results: The GPⅣ level of stationary platelet, the GPⅣ and TSP level of activated platelet in MS patients were higher than those in the healthy significantly (P < 0. 01,< 0. 05, < 0. 005 ), while the TSP level of stationary platelet in the patients was not different to the healthy (P > 0. 05). The GPⅣ redistribution on the activated platelet surface was apparently inhibited by dauricine (50 μmol/L, P < 0. 05 - 0. 005) and the release of TSP from intracellular α-granules was inhibited by dauricine only in the activated platelets induced by thrombin of low concentration (0. 05 U/ml and 0. 1 U/ml, P < 0. 05 - 0. 01 ), inhibiting effect was not found in those activated with high concentration of thrombin. Conclusion: The activity and reactivity to thrombin of platelets increased in MS patients, and dauricine was able to reduce the occurrence of the irreversible platelet aggregation in MS patients.Original article on CJIM(Chin) 1998; 18(8): 461

原发与继发免疫性血小板减少症患者血小板膜糖蛋白特异性抗体及其与出血评分关系的研究

目的探讨原发与继发免疫性血小板减少症(ITP)患者抗GPⅡb/Ⅲa及GPΙb/Ⅸ抗体的表达、抗体阳性表达与出血评分的关系,以及不同抗体类型出血评分的差异,为原发与继发ITP患者的诊治和出血严重程度提供临床依据。方法选取2013年10月—2020年8月在新疆医科大学第一附属医院诊断为原发ITP患者(42例)及继发ITP患者(42例)为研究对象,所有患者入院时采用ITP出血评分量表行出血评分。应用改良MAIPA法检测患者抗GPⅡb/Ⅲa和抗GPΙb/Ⅸ抗体。结果原发与继发组患者抗GPⅡb/Ⅲa抗体、抗GPΙb/Ⅸ抗体阳性率比较,差异无统计学意义(P>0.05),原发组患者抗体表达以抗GPⅡb/Ⅲa抗体为主,继发组抗体表达以抗GPΙb/Ⅸ抗体为主,两者抗体阳性构成比较,差异有统计学意义(P<0.05)。继发组患者整体出血程度较原发组重(P<0.05)。抗体阳性表达与出血程度的关系:(1)抗GPⅡb/Ⅲa抗体阳性患者出血程度较抗体阴性患者重(P<0.05)。(2)抗GPΙb/Ⅸ抗体阳性患者出血程度较抗体阴性患者重(P<0.05),双抗体阳性患者出血程度较抗体阴性患者重(P<0.05)。结论抗GPⅡb/Ⅲa抗体、抗GPΙb/Ⅸ抗体阳性表达对原发与继发ITP无鉴别意义,但原发ITP患者抗体表达以抗GPⅡb/Ⅲa抗体为主,继发ITP患者抗体表达以抗GPΙb/Ⅸ抗体为主。继发ITP患者临床出血程度较原发ITP患者重。抗GPⅡb/Ⅲa抗体、抗GPΙb/Ⅸ抗体及抗体双阳性患者出血程度较抗体阴性患者重。

龙柴降血方对原发性血小板增多症患者凝血功能及血小板活化蛋白的影响

目的观察龙柴降血方对原发性血小板增多症(ET)患者凝血功能及血小板活化蛋白的影响。方法选取2020年1月—2021年10月中国中医科学院西苑医院收治的ET患者22例,给予龙柴降血方治疗4个月,观察治疗前后血栓弹力图指标[凝血时间(R)、凝血速率(K)、纤维蛋白功能(Angle)、血栓最大振幅(MA)、血栓最大振幅时间(TMA)、即时振幅(A)、30 min振幅(A30)、从血样开始检测到曲线分叉所需时间(SP)、血凝块溶解时间(CLT)]、高凝状态发生率和积分变化。选取其中15例ET患者,采用平行反应监测(PRM)技术检测患者治疗前后血小板活化蛋白[血小板膜糖蛋白Ibα(GPIbα)、糖蛋白VI(GPVI)、选择素-P(SELP)]表达水平,分析比较血小板聚集改善患者和血小板聚集增强患者上述各蛋白表达水平的差异;取5例健康者和10例ET患者治疗前后血清,采用Western blot法检测血清GPIbα表达情况;分析15例ET患者MA与血清GPIbα表达水平的相关性。结果与治疗前比较,龙柴降血方治疗后MA、CLT、高凝状态发生率、高凝状态积分和血清GPIbα、GPVI表达水平均明显降低(P均<0.05),血清SELP表达水平无明显变化(P>0.05)。治疗后血小板聚集改善患者血清GPIbα表达水平明显低于血小板聚集增强患者(P<0.05),GPVI表达水平无明显变化(P>0.05)。与健康人相比,10例ET患者治疗前血清GPIbα相对表达量明显增高(P<0.05);10例ET患者治疗后血清GPIbα相对表达量较治疗前明显降低(P<0.05)。龙柴降血方治疗后MA下降与GPIbα表达下调呈正相关(r=0.6986,P<0.05)。结论龙柴降血方能够抑制ET患者血小板聚集,改善高凝状态,其机制可能与抑制GPIbα蛋白介导的血小板活化信号通路有关。

慢性非缺血性心力衰竭患者血小板PAC-1和CD62p的表达及其与心功能的关系

目的探讨慢性非缺血性心力衰竭患者血小板膜糖蛋白纤维蛋白原受体(PAC-1)和P选择素(CD62p)的表达及其与心功能的关系。方法选取2019年1月至2022年1月天津市南开医院收治的185例慢性非缺血性心力衰竭患者作为观察组,根据纽约心脏病学会(NYHA)心功能分级将观察组患者分为心功能Ⅱ级组58例、心功能Ⅲ级组88例和心功能Ⅳ级组39例,根据左室射血分数(LVEF)将观察组患者分为射血分数保留心衰组(HFpEF)123例、射血分数临界值心衰组(HFmrEF)25例和射血分数下降心衰组(HFrEF)37例,再以B型钠尿肽(BNP)中位数为界将观察组患者分为高BNP组109例和低BNP组76例;另选取同期心功能正常的就诊者55例作为对照组。比较各组患者的基本临床信息、生化、BNP指标和PAC-1、CD62p的表达水平,采用Pearson相关分析法分析PAC-1、CD62p水平与BNP、LVEF的关系。结果观察组患者的PAC-1、CD62p水平分别为(23.67±16.54)%、(10.43±9.19)%,明显高于对照组的(9.33±9.63)%、(4.24±5.49)%,差异均有统计学意义(P<0.05);不同心功能分级患者对比发现,PAC-1、BNP水平为Ⅳ级>Ⅲ级>Ⅱ级>对照组,CD62p水平为Ⅳ级>Ⅲ级、Ⅱ级>对照组,差异均有统计学意义(P<0.05);不同LVEF分级患者对比发现,PAC-1水平为HFrEF组>HFmrEF组、HFpEF组>对照组,BNP水平为HFrEF组>HFmrEF组>HFpEF组>对照组,HFpEF组、HFmrEF组、HFrEF组CD62p水平分别为(10.72±9.17)%、(9.87±11.19)%、(9.84±7.88)%,明显高于对照组的(4.24±5.49)%,差异均有统计学意义(P<0.05);高BNP组患者的PAC-1、CD62p分别为(26.97±16.94)%、(11.05±9.62)%,明显高于低BNP组的(13.80±12.82)%、(6.97±7.54)%,差异均有统计学意义(P<0.05);经Pearson相关分析结果显示,PAC-1、CD62p与BNP呈正相关(r=0.363、0.182,P<0.05),PAC-1与LVEF呈负相关(r=-0.297,P<0.05)。结论慢性非缺血性心力衰竭患者的PAC-1、CD62p水平均明显增高,且与心功能有关,检测其水平有助于为患者的病情评估及临床治疗提供参考依据。

GPIa C807T和G873A基因多态性对血小板聚集抑制率的影响

目的:探讨GPIa C807T和G873A基因多态性对血小板聚集抑制率的影响,为临床个体化抗血小板聚集治疗提供实验数据支持。方法:收集正在使用阿司匹林抗血小板聚集治疗的住院患者80例,采用血栓弹力图仪检测血小板聚集抑制率,根据聚集抑制率检测结果分为阿司匹林抵抗(aspirin resistance,AR)组(共10例)和阿司匹林敏感(aspirin sensitivity,AS)组(共70例),分析GPIa C807T、G873A基因型及其等位基因在两组分布状况以及两者患者临床资料与实验检测指标关系。结果:AR组807T、873G等位基因高于AS组(χ^(2)=4.039、4.354,P=0.044、0.037);AR组高血压病史患病率、卒中史高于AS组(χ^(2)=4.612、4.737,P=0.032、0.030);AR组血浆D-二聚体(D-D)、血清甘油三酯(TG)高于AS组(t=2.499、2.276,P=0.016、0.033),而AR组血小板聚集抑制率、血清葡萄糖低于AS组(t=15.352、3.076,P<0.001、0.005)。结论:GPIa C807T和G873A基因多态性与AR存在相关性,建议联合检测两基因位点的多态性并结合血小板聚集抑制率,共同指导临床个体化抗血小板聚集治疗。

全麻下扁桃体切除术对OSAHS患儿发音特征及血液中PCT、GMP-140、T淋巴细胞亚群的影响

目的探讨全麻下扁桃体切除术对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患儿发音特征及血液中降钙素原(PCT)、血小板膜蛋白-140(GMP-140)、T淋巴细胞亚群等的影响。方法随机选取2020年6月—2022年3月在西安市儿童医院耳鼻咽喉头颈外科行全麻下扁桃体切除术的OSAHS患儿43例。分别于术前及术后第1、3个月时检测患儿发音特征及血清中PCT、GMP-140、T淋巴细胞亚群的水平,同时检测患儿的睡眠情况。结果与术前比较,术后第1、3个月患儿发/a/时最长发音时间明显延长,第二共振峰明显增强(F=43.07、39.65,P<0.05);与术前比较,术后第1、3个月患儿发/i/时最长发音时间明显延长,第四共振峰明显增强(F=21.43、44.25,P<0.05)。与术前比较,术后第1、3个月患儿血液中PCT、GMP-140、CD8^(+)水平及呼吸暂停低通气指数明显降低(F=29.67~112.86,P<0.05),血液中CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平及夜间最低血氧饱和度水平、魁北克睡眠问卷评分明显升高(F=12.15~234.11,P<0.05)。结论全麻下扁桃体切除术能够使OSAHS患儿发/a/、/i/时最长发音时间明显延长,发音特征明显改善,同时可降低患儿炎症反应,改善睡眠质量,并对恢复免疫功能有积极作用。

免疫性血小板减少症时检测血小板相关抗体及血小板膜糖蛋白的意义

为探讨血小板表面血小板相关抗体 (血小板相关免疫球蛋白 )及血小板膜糖蛋白在免疫性血小板减少症中的诊断及预后评价方面的应用价值 ,采用流式细胞术 (FCM)测定了 76例血小板减少症患者及 30名正常人血小板表面血小板相关免疫球蛋白 (PAIg)及血小板膜糖蛋白 (CD4 1,CD6 1,GPIIb/IIIa)。结果发现 ,初治 38例特发性血小板减少性紫癜 (ITP)患者中血小板相关抗体 (PAIgG、PAIgM、PAIgA)在血小板表面阳性百分率均高于正常对照组 (P <0 .0 0 1) ,血小板膜糖蛋白均低于正常对照组 (P <0 .0 1) ;9例经激素治疗的ITP患者PAIgG ,PAIgM ,PAIgA与正常对照组相比差异无统计学意义 (P >0 .0 5 ) ,血小板膜糖蛋白与正常对照组相比差异无统计学意义(P >0 .0 2 ) ;继发性血小板减少症患者 (慢性再生障碍性贫血、白血病、SLE、Evans综合征、甲亢、乙肝后肝硬化脾功能亢进 )血小板相关抗体在血小板表面阳性百分率均高于正常对照组 (P <0 .0 0 1) ,血小板膜糖蛋白均低于正常对照组 (P <0 .0 5 ) ;12例治疗有效患者治疗后血小板相关抗体较治疗前下降 (P <0 .0 5 ) ,血小板膜糖蛋白上升 ,其差异有统计学意义 (P <0 .0 1)。结论 :FCM用于免疫性血小板减少症患者的血小板相关抗体及血小板膜糖蛋白检测 ,具有灵敏、快速、简便的?

冠状动脉内注射替罗非班对老年糖尿病急性心肌梗死患者的影响

目的探讨冠状动脉内注射替罗非班对老年糖尿病合并急性心肌梗死(AMI)患者急诊PCI的近期疗效和安全性。方法选择急诊PCI的老年糖尿病合并AMI患者97例,随机分为对照组(A组)49例、替罗非班组(B组)48例;另选择同期急诊PCI给予替罗非班治疗的非老年糖尿病合并AMI患者(C组)129例。对3组冠状动脉病变特征、并发症发生率等进行比较。结果与A组比较,B组和C组PCI术后TIMI 3级血流、心肌灌注3级明显升高(P<0.01),心肌灌注0～1级、2级、平均住院天数、梗死后心绞痛、恶性心律失常发生率明显降低(P<0.05,P<0.01)。3组单支、双支和3支病变、入院到球囊扩张平均时间、住院期间再梗死、支架内血栓、心源性休克发生率和30d病死率等无明显变化(P>0.05)。结论替罗非班能有效改善老年糖尿病合并AMI患者的TIMI血流和心肌灌注分级,降低梗死后心绞痛、恶性心律失常等并发症的发生。并不增加严重出血并发症。

缺血性心力衰竭患者血小板功能状态的研究

目的：观察缺血性心力衰竭（心衰）患者血小板功能状态的变化。 方法：采用放射免疫法及流式细胞技术测定４５例缺血性心衰患者（心衰组）血浆凝血烷Ａ２（ＴＸＡ２）的代谢产物凝血烷Ｂ２（ＴＸＢ２）及前列环素（ＰＧＩ２）的代谢产物６－酮前列腺素１α（６－ｋｅｔｏＰＧＦ１α）、血小板膜糖蛋白ＣＤ６２Ｐ、ＣＤ６１（Ⅲａ）及血小板聚集率，并与４１例ＮＹＨＡ分级心功能正常的冠心病患者（对照组）进行对照。 结果：心衰组患者ＴＸＢ２的水平、ＣＤ６２Ｐ、ＣＤ６１及血小板聚集率均显著高于对照组（Ｐ均＜０．０１＝，６－ｋｅｔｏ－ＰＧＦ１α明显低于对照组（Ｐ＜０．０５＝。 结论：缺血性心衰患者血小板呈相对激活状态，有利于血小板的粘附、聚集及血栓前状态的形成。