血小板高敏性在“白细胞捕获”过程中的作用  

The effect of platelet hyper-reactivity on leukocyte traping

作　　者：叶开创[1] 陆信武[1] 李维敏[1] 刘晓兵[1] 殷敏毅[1] 施慧华[1] 蒋米尔[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院血管外科上海交通大学血管病诊治中心,上海200011

出　　处：《中国血管外科杂志（电子版）》2010年第4期210-212,222,共4页Chinese Journal of Vascular Surgery(Electronic Version)

基　　金：国家自然科学基金(30772104)

摘　　要：目的探讨下肢原发性慢性静脉功能不全(PCVI)患者血小板高敏性对单核细胞跨内皮迁移的影响。方法根据纳入和排除标准选择PCVI患者和正常人群,提取两组受试者不同体位时下肢静脉血液并分离其洗涤血小板悬液,建立人脐静脉内皮细胞单层的transwell膜,根据洗涤血小板来源分成空白对照组、PCVI患者站立30min组、正常人站立30min组、PCVI患者晨起平卧位组及正常人晨起平卧位组,各组transwell上室中注入200μl单核细胞悬液(单核细胞浓度为5×105个/ml)和对应的洗涤血小板悬液200μl共同培养,分别在2、4、8、24h后计数并比较各组transwell下室中单核细胞数量。结果在接种共同培养2h和4h后,各组transwell下室中单核细胞数量无明显差异(P>0.05);自8h后和24h后,PCVI患者站立30min时较其他组别transwell下室中单核细胞数量增多,差异具有统计学意义(P<0.05),其余各组transwell下室中单核细胞数量比较,差异无统计学意义(P>0.05)。结论静脉压力变化引起的血小板活性异常是导致PCVI患者静脉管壁单核细胞异常增多的重要原因,可能与该病的发生、发展有密切的关系。Objective To investigate the effect of platelet hyper-reactivity on the monocyte transendothelial migration in patients with primary chronic venous insufficiency (PCVI). Methods PCVI patients and normal people were selected according to included and excluded criterions. After taking anticoagulated blood and from superficial venous blood at the level of dorsum of foot was obtained from 12 patients with PCVI and 12 normal subjects in different postures, washed platelet plasma was isolated. Subjects were divided into five groups, including control group, group 1 (PCVI patients after standing for 30 minutes), group 2 (normal subjects after standing for 30 minutes), group 3 (PCVI patients under supine position in the morning), group 4 (control subjects under supine position in the morning). 200μl of monocyte suspension(5×105/ml) and 200μl of its washed platelet plasma were cocultured in up chamber, and analyzed monocyte number in lower chamber after 2, 4, 8, 24-hour among these 5 groups. Results After coculturing for 2h and 4h in up chamber, there were no significant differences in monocytes in lower chamber among five groups(P>0.05). After coculturing for 8 h and 24 h, monocytes in lower chamber of group 1 were significantly more than other groups(P<0.05), and there were no significant differences among other groups (P>0.05). Conclusion Platelet hyper-reactivity in patients with CVI, which resulted from venous hypertension, stimulated more monocytes transendothelial migration, which might be closely related with monocytes infiltration in diseased vein wall and playing a major role in the pathophysiology of PCVI.

关 键 词：静脉高压 慢性静脉功能不全 血小板高敏性 单核细胞 跨内皮迁移 

分 类 号：R654.4[医药卫生—外科学]